Provider Demographics
NPI:1730305681
Name:WILSON, ASHLEY SUZANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:SUZANNE
Last Name:WILSON
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:264 THETFORD ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5064
Mailing Address - Country:US
Mailing Address - Phone:828-651-9767
Mailing Address - Fax:828-651-9705
Practice Address - Street 1:264 THETFORD ST
Practice Address - Street 2:SUITE 120
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-5064
Practice Address - Country:US
Practice Address - Phone:828-651-9767
Practice Address - Fax:828-651-9705
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-01669363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant