Provider Demographics
NPI:1538465570
Name:ADAMS, ASHLEY FULLER (NP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:FULLER
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 E SOUTH BLVD
Mailing Address - Street 2:SUITE 806
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2001
Mailing Address - Country:US
Mailing Address - Phone:334-613-7029
Mailing Address - Fax:334-613-7030
Practice Address - Street 1:2055 E SOUTH BLVD
Practice Address - Street 2:SUITE 806
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2001
Practice Address - Country:US
Practice Address - Phone:334-613-7029
Practice Address - Fax:334-613-7030
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily