Provider Demographics
NPI:1417923459
Name:COLLINS, ASHLI N (MD)
Entity Type:Individual
Prefix:MS
First Name:ASHLI
Middle Name:N
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 S HIGHWAY 53
Mailing Address - Street 2:P.O. BOX 247
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-8568
Mailing Address - Country:US
Mailing Address - Phone:502-225-6277
Mailing Address - Fax:502-225-6278
Practice Address - Street 1:2307 S HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-8568
Practice Address - Country:US
Practice Address - Phone:502-225-6277
Practice Address - Fax:502-225-6278
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35804208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65934945Medicaid
KY64032980Medicaid
KY65934945Medicaid