Provider Demographics
NPI:1699387837
Name:PERRY, ASHLYNN TAKARRA
Entity Type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:TAKARRA
Last Name:PERRY
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 1:26380 DRAKEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1907
Mailing Address - Country:US
Mailing Address - Phone:216-612-2909
Mailing Address - Fax:
Practice Address - Street 1:26380 DRAKEFIELD AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-1907
Practice Address - Country:US
Practice Address - Phone:216-612-2909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401955260417376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide