Provider Demographics
NPI:1730304601
Name:COLVIN, ASHLEE SUZANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEE
Middle Name:SUZANN
Last Name:COLVIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:SUZANN
Other - Last Name:COLVIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3809 BANYAN GROVE LN
Mailing Address - Street 2:APT 307
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7471
Mailing Address - Country:US
Mailing Address - Phone:813-454-3434
Mailing Address - Fax:
Practice Address - Street 1:3809 BANYAN GROVE LN
Practice Address - Street 2:APT 307
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7471
Practice Address - Country:US
Practice Address - Phone:813-454-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist