Provider Demographics
NPI:1417725037
Name:GAUSE, ASHLEY LADAWN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LADAWN
Last Name:GAUSE
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 1:3656 S IRBY ST STE A
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-5225
Mailing Address - Country:US
Mailing Address - Phone:803-250-6734
Mailing Address - Fax:833-587-1829
Practice Address - Street 1:3656 S IRBY ST STE A
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-5225
Practice Address - Country:US
Practice Address - Phone:803-250-6734
Practice Address - Fax:833-587-1829
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory