Provider Demographics
NPI:1760987259
Name:TRAVERSA, ASHLEY GENTILE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:GENTILE
Last Name:TRAVERSA
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 1:3100 TOWER BLVD FL 6
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-0034
Mailing Address - Country:US
Mailing Address - Phone:919-419-5500
Mailing Address - Fax:
Practice Address - Street 1:3100 TOWER BLVD FL 6
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-0034
Practice Address - Country:US
Practice Address - Phone:919-419-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010416163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology