Provider Demographics
NPI:1891236709
Name:SUTTON, ASHLEY COBANE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:COBANE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 PARADISE LN
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-9737
Mailing Address - Country:US
Mailing Address - Phone:859-619-7624
Mailing Address - Fax:
Practice Address - Street 1:177 BURT RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2457
Practice Address - Country:US
Practice Address - Phone:859-276-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2219363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant