Provider Demographics
NPI:1851997803
Name:TODD, ASHLEY (BS, RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TODD
Suffix:
Gender:F
Credentials:BS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12281 PINHOOK RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23146-1514
Mailing Address - Country:US
Mailing Address - Phone:804-986-2154
Mailing Address - Fax:
Practice Address - Street 1:1602 SKIPWITH RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5298
Practice Address - Country:US
Practice Address - Phone:804-289-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001249768367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered