Provider Demographics
NPI:1659057891
Name:KIDD, ASHLEE NICOLE
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:NICOLE
Last Name:KIDD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 JOHN MUIR DR APT A519
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1063
Mailing Address - Country:US
Mailing Address - Phone:510-747-2680
Mailing Address - Fax:415-349-3245
Practice Address - Street 1:515 JOHN MUIR DR APT A519
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1063
Practice Address - Country:US
Practice Address - Phone:510-747-2680
Practice Address - Fax:415-349-3245
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker