Provider Demographics
NPI:1851408157
Name:ASH, MICHELLE MADELEINE (NP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:MADELEINE
Last Name:ASH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25905 JUBAN RD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6066
Mailing Address - Country:US
Mailing Address - Phone:225-380-0075
Mailing Address - Fax:
Practice Address - Street 1:25905 JUBAN RD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6066
Practice Address - Country:US
Practice Address - Phone:225-380-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03154030Medicaid
MSP00295675OtherRAILROAD MEDICARE
MSP00295675OtherRAILROAD MEDICARE
MS500002054Medicare ID - Type Unspecified