Provider Demographics
NPI:1619370863
Name:OLIPHANT, ASHLEY BETH (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:BETH
Last Name:OLIPHANT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:201 S OAKRIDGE DR
Mailing Address - Street 2:SUITE 1535
Mailing Address - City:HUDSON OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76087-1793
Mailing Address - Country:US
Mailing Address - Phone:410-569-0044
Mailing Address - Fax:
Practice Address - Street 1:5 BEL AIR SOUTH PKWY
Practice Address - Street 2:SUITE 1535
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6091
Practice Address - Country:US
Practice Address - Phone:410-569-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR200204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily