Provider Demographics
NPI:1437645348
Name:FORE, ASHLEY RUBINSTEIN (MSN, RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RUBINSTEIN
Last Name:FORE
Suffix:
Gender:F
Credentials:MSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 AMBER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-9537
Mailing Address - Country:US
Mailing Address - Phone:386-689-2417
Mailing Address - Fax:
Practice Address - Street 1:1044 AMBER RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-9537
Practice Address - Country:US
Practice Address - Phone:386-689-2417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-86263163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant