Provider Demographics
NPI:1780678839
Name:BUREN EMRICH, ASHLEY M (MS OTR L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:BUREN EMRICH
Suffix:
Gender:F
Credentials:MS OTR L
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:BUREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTRL
Mailing Address - Street 1:PO BOX 740041
Mailing Address - Street 2:DEPT 6150
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-7441
Mailing Address - Country:US
Mailing Address - Phone:502-562-0398
Mailing Address - Fax:502-585-0021
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 650
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1846
Practice Address - Country:US
Practice Address - Phone:502-561-4263
Practice Address - Fax:502-561-4221
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2624225X00000X, 225XH1200X
IN31003455A225X00000X
IL056-006199225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN233603CMedicare PIN
KY0988909Medicare PIN