Provider Demographics
NPI:1407486277
Name:WEISSE, ASHLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WEISSE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:HARTFORD HOSPITAL CVO PROVIDER ENROLLMENT
Mailing Address - Street 2:80 SEYMOUR STREET
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-5037
Mailing Address - Country:US
Mailing Address - Phone:860-972-3495
Mailing Address - Fax:860-972-7040
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-545-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2020-03-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical