Provider Demographics
NPI:1366462087
Name:MESSICK-HITE, ASHLEY C (C-PA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:C
Last Name:MESSICK-HITE
Suffix:
Gender:F
Credentials:C-PA
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:C
Other - Last Name:MESSICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:C-PA
Mailing Address - Street 1:PO BOX 802
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-0802
Mailing Address - Country:US
Mailing Address - Phone:931-800-6400
Mailing Address - Fax:931-800-6401
Practice Address - Street 1:151 LEDFORD MILL RD
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2278
Practice Address - Country:US
Practice Address - Phone:931-800-6400
Practice Address - Fax:931-800-6401
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000000929363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3063983OtherBC/BS OF TENNESSEE
TN3373903Medicaid
TN3373903Medicare ID - Type Unspecified
TN3373903Medicaid