Provider Demographics
NPI:1770232985
Name:THOMAS, ASHLY SOBY (NP)
Entity Type:Individual
Prefix:
First Name:ASHLY
Middle Name:SOBY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 GOLLS GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4810
Mailing Address - Country:US
Mailing Address - Phone:267-760-5964
Mailing Address - Fax:
Practice Address - Street 1:735 FITZWATERTOWN RD STE 1
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1338
Practice Address - Country:US
Practice Address - Phone:215-657-2012
Practice Address - Fax:215-657-2018
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025334363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner