Provider Demographics
NPI:1538670088
Name:ENNEKING, ASHLEY CHEYENNE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CHEYENNE
Last Name:ENNEKING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 SW WAYNE AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-1745
Mailing Address - Country:US
Mailing Address - Phone:905-539-1408
Mailing Address - Fax:
Practice Address - Street 1:2950 SW WAYNE AVE APT 16
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-1745
Practice Address - Country:US
Practice Address - Phone:905-539-1408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer