Provider Demographics
NPI:1376882894
Name:AUSTIN, ASHLEY JEANINE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:JEANINE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:JEANINE
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:479 BRADLEY LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1445
Mailing Address - Country:US
Mailing Address - Phone:216-849-5231
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA-14211367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered