Provider Demographics
NPI:1710315189
Name:NASSAR, ASHLEY (CRNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:NASSAR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7580 PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8464
Mailing Address - Country:US
Mailing Address - Phone:724-322-6964
Mailing Address - Fax:
Practice Address - Street 1:1050 S CEDAR CREST BLVD STE 201
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-5454
Practice Address - Country:US
Practice Address - Phone:610-351-6605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013277363LF0000X
NE111885363LF0000X
IAA141895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily