Provider Demographics
NPI:1558785154
Name:KONTRA, ASHLEY LYNN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:LYNN
Last Name:KONTRA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:3521 SILVERSIDE RD STE 2J
Mailing Address - Street 2:CONCORD PLAZA, QUILLEN BLDG
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4900
Mailing Address - Country:US
Mailing Address - Phone:302-543-5454
Mailing Address - Fax:302-327-4200
Practice Address - Street 1:3521 SILVERSIDE RD STE 2J
Practice Address - Street 2:CONCORD PLAZA, QUILLEN BLDG
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4900
Practice Address - Country:US
Practice Address - Phone:302-543-5454
Practice Address - Fax:302-327-4200
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC50000921363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000024689Medicaid
DE1000024689Medicaid