Provider Demographics
NPI:1659626786
Name:INGHAM, ASHLEY RAE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:RAE
Last Name:INGHAM
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Mailing Address - Street 1:2255 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1595
Mailing Address - Country:US
Mailing Address - Phone:724-463-0476
Mailing Address - Fax:724-463-1196
Practice Address - Street 1:2255 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1595
Practice Address - Country:US
Practice Address - Phone:724-463-0476
Practice Address - Fax:714-463-1196
Is Sole Proprietor?:No
Enumeration Date:2012-07-15
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA055601363AM0700X
SCMPA.2156363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant