Provider Demographics
NPI:1821666264
Name:ADER, ASHLEY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:ADER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 WHITEFOORD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1736
Mailing Address - Country:US
Mailing Address - Phone:717-315-6529
Mailing Address - Fax:
Practice Address - Street 1:97 WHITEFOORD AVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30317-1736
Practice Address - Country:US
Practice Address - Phone:717-315-6529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-13
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN270404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty