Provider Demographics
NPI:1427407865
Name:CALVERT, ASHLEY DIANNE (NP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:DIANNE
Last Name:CALVERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8000 W FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-1414
Mailing Address - Country:US
Mailing Address - Phone:314-553-2486
Mailing Address - Fax:314-553-3702
Practice Address - Street 1:8000 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1414
Practice Address - Country:US
Practice Address - Phone:314-553-2486
Practice Address - Fax:314-553-3702
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016018342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner