Provider Demographics
NPI:1649573627
Name:FLEENOR, ASHLEY DANIELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DANIELLE
Last Name:FLEENOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 DRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2605
Mailing Address - Country:US
Mailing Address - Phone:304-253-6060
Mailing Address - Fax:304-929-2248
Practice Address - Street 1:275 DRY HILL RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2605
Practice Address - Country:US
Practice Address - Phone:304-253-6060
Practice Address - Fax:304-929-2248
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV363A00000X
WV1521363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant