Provider Demographics
NPI:1518253145
Name:MARSHALL, ASHLEY NICOLE (PHD, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:NICOLE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PHD, LAT, ATC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 32071
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28608-6111
Mailing Address - Country:US
Mailing Address - Phone:828-262-2560
Mailing Address - Fax:
Practice Address - Street 1:1179 STATE FARM RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4943
Practice Address - Country:US
Practice Address - Phone:352-375-4683
Practice Address - Fax:352-375-4805
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-41712255A2300X
FLAL29562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer