Provider Demographics
NPI:1558930446
Name:JUSTICE, ASHLEY N
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:N
Last Name:JUSTICE
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 1:1587 ROAD CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ELKHORN CITY
Mailing Address - State:KY
Mailing Address - Zip Code:41522-8404
Mailing Address - Country:US
Mailing Address - Phone:606-422-1397
Mailing Address - Fax:
Practice Address - Street 1:424 BOB AMOS DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-2035
Practice Address - Country:US
Practice Address - Phone:606-422-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program