Provider Demographics
NPI:1619373545
Name:ROSS, ASHLEY (NP-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 EATON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-2716
Mailing Address - Country:US
Mailing Address - Phone:513-896-2200
Mailing Address - Fax:513-894-0096
Practice Address - Street 1:520 EATON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2716
Practice Address - Country:US
Practice Address - Phone:513-896-2200
Practice Address - Fax:513-894-0096
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17625-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0152073Medicaid
OHH289820Medicare PIN
OHH289821Medicare PIN