Provider Demographics
NPI:1407318579
Name:COLLINS, ASHLEY NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 N FAIRFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2783
Mailing Address - Country:US
Mailing Address - Phone:937-558-3900
Mailing Address - Fax:937-558-3999
Practice Address - Street 1:2145 N FAIRFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2783
Practice Address - Country:US
Practice Address - Phone:937-558-3900
Practice Address - Fax:937-558-3999
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.016552207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine