Provider Demographics
NPI:1629563879
Name:SAYLES, ASHLEY C (CRNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C
Last Name:SAYLES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 FREDERICK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4647
Mailing Address - Country:US
Mailing Address - Phone:410-788-6565
Mailing Address - Fax:410-747-4688
Practice Address - Street 1:405 FREDERICK RD STE 210
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4647
Practice Address - Country:US
Practice Address - Phone:410-788-6565
Practice Address - Fax:410-747-4688
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR214621363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR214621OtherLICENSE
MD777854600Medicaid