Provider Demographics
NPI:1821616137
Name:KINGDON, ASHLEY (MBHCA, LNC,BSN, RN,)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KINGDON
Suffix:
Gender:F
Credentials:MBHCA, LNC,BSN, RN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 LINCOLN AVE SW
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-3011
Mailing Address - Country:US
Mailing Address - Phone:605-352-4663
Mailing Address - Fax:605-352-1373
Practice Address - Street 1:1143 LINCOLN AVE SW
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-3011
Practice Address - Country:US
Practice Address - Phone:605-352-4663
Practice Address - Fax:605-352-1373
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR044464163WC1500X, 163WG0000X, 364SH0200X, 163WH0200X
SDRO44464163WC1600X, 163WX0106X
372500000X, 372600000X, 374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide