Provider Demographics
NPI:1437516127
Name:KORSON, ASHLEY
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:
Last Name:KORSON
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 1:604 S WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:MO
Mailing Address - Zip Code:65360-1856
Mailing Address - Country:US
Mailing Address - Phone:660-238-7436
Mailing Address - Fax:
Practice Address - Street 1:604 S WINDSOR ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:MO
Practice Address - Zip Code:65360-1856
Practice Address - Country:US
Practice Address - Phone:660-238-7436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015002256163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse