Provider Demographics
NPI:1467130468
Name:BLUE, ASHLEY (BIRTH DOULA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BLUE
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 TERRANOVA DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-3429
Mailing Address - Country:US
Mailing Address - Phone:863-589-3309
Mailing Address - Fax:
Practice Address - Street 1:619 TERRANOVA DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-3429
Practice Address - Country:US
Practice Address - Phone:863-589-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula