Provider Demographics
NPI:1467225037
Name:MYERS, ASHLEY (RDN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 TENNIS AVE
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-4248
Mailing Address - Country:US
Mailing Address - Phone:215-688-8625
Mailing Address - Fax:
Practice Address - Street 1:145 TENNIS AVE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-4248
Practice Address - Country:US
Practice Address - Phone:215-688-8625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN008164133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered