Provider Demographics
NPI:1801852546
Name:ASHBY, KIRSTEN L (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:L
Last Name:ASHBY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42719-0180
Mailing Address - Country:US
Mailing Address - Phone:270-932-3694
Mailing Address - Fax:270-932-2154
Practice Address - Street 1:1700 OLD LEBANON ROAD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718
Practice Address - Country:US
Practice Address - Phone:270-932-3694
Practice Address - Fax:270-932-2154
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1091045367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00000247358OtherBCBS
KY74005935Medicaid
KY9214OtherBLUEGRASS FAMILY HEALTH
KY0664013Medicare ID - Type Unspecified