Provider Demographics
NPI:1477017861
Name:THOMAS, ASHLEY HALCOMB (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:HALCOMB
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CALVERT DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3520
Mailing Address - Country:US
Mailing Address - Phone:318-443-9634
Mailing Address - Fax:318-443-9809
Practice Address - Street 1:37 CALVERT DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3520
Practice Address - Country:US
Practice Address - Phone:318-443-9634
Practice Address - Fax:318-443-9809
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN098999163WP0200X
LAL-36622163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1215156898OtherRHODES PEDIATRIC CLINIC