Provider Demographics
NPI:1790072254
Name:DUDDEN, ASHLEY ROSE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ROSE
Last Name:DUDDEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:WORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:4035 ELECTRIC RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8449
Mailing Address - Country:US
Mailing Address - Phone:540-772-8670
Mailing Address - Fax:540-772-7901
Practice Address - Street 1:4035 ELECTRIC RD STE A
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8449
Practice Address - Country:US
Practice Address - Phone:540-772-8670
Practice Address - Fax:540-772-7901
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN615194363L00000X
PASP010962363L00000X
NY337934363LF0000X
VA0024177881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner