Provider Demographics
NPI:1477270148
Name:BISBY, ASHLEY LANE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LANE
Last Name:BISBY
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2914 WATAUGA RD APT 707
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3868
Mailing Address - Country:US
Mailing Address - Phone:919-608-3733
Mailing Address - Fax:
Practice Address - Street 1:301 LOUIS ST STE 101
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-5195
Practice Address - Country:US
Practice Address - Phone:423-246-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program