Provider Demographics
NPI:1437898483
Name:HARRIS, ASHLEY J (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44506-1633
Mailing Address - Country:US
Mailing Address - Phone:330-718-2290
Mailing Address - Fax:
Practice Address - Street 1:128 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44506-1633
Practice Address - Country:US
Practice Address - Phone:330-718-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.152841.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse