Provider Demographics
NPI:1407481559
Name:PAULDIN, ASHLEY JASMINE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JASMINE
Last Name:PAULDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 ODUM RD
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-3600
Mailing Address - Country:US
Mailing Address - Phone:205-351-0149
Mailing Address - Fax:
Practice Address - Street 1:919 ODUM RD
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-3600
Practice Address - Country:US
Practice Address - Phone:205-351-0149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF06192090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily