Provider Demographics
NPI:1497336747
Name:BLEKICKI, ASHLEY SUZANNE (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:SUZANNE
Last Name:BLEKICKI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CHADWICK SQUARE CT STE C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-3200
Mailing Address - Country:US
Mailing Address - Phone:828-697-2660
Mailing Address - Fax:
Practice Address - Street 1:120 CHADWICK SQUARE CT STE C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-3200
Practice Address - Country:US
Practice Address - Phone:828-697-2660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ256487363LP0808X
NC278166363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health