Provider Demographics
NPI:1598156044
Name:LONG, ASHTON RECHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:RECHELLE
Last Name:LONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 HARTFORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-351-2750
Mailing Address - Fax:401-351-6611
Practice Address - Street 1:1126 HARTFORD AVENUE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919
Practice Address - Country:US
Practice Address - Phone:401-351-2750
Practice Address - Fax:401-351-6611
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIAPRN00010363LW0102X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health