Provider Demographics
NPI:1679263230
Name:RICHBURG, ASHLEY (NP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:RICHBURG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BETLOU JAMES PL
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4486
Mailing Address - Country:US
Mailing Address - Phone:443-756-1954
Mailing Address - Fax:
Practice Address - Street 1:18 BETLOU JAMES PL
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-4486
Practice Address - Country:US
Practice Address - Phone:443-756-1954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR183863363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily