Provider Demographics
NPI:1518202977
Name:ASHWORTH, CAROL JEAN (LPN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
Last Name:ASHWORTH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4092 COUNTY ROAD 52
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-8577
Mailing Address - Country:US
Mailing Address - Phone:740-532-0403
Mailing Address - Fax:
Practice Address - Street 1:2932 S. 5TH STREET
Practice Address - Street 2:SANCTUARY OF THE OHIO VALLEY
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638
Practice Address - Country:US
Practice Address - Phone:740-532-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.070579164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse