Provider Demographics
NPI:1912374893
Name:HEATH, ASHLEY JEAN (CNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JEAN
Last Name:HEATH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-543-8730
Mailing Address - Fax:330-543-3836
Practice Address - Street 1:1 PERKINS SQ
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1063
Practice Address - Country:US
Practice Address - Phone:330-543-8730
Practice Address - Fax:330-543-3836
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18026-NP363L00000X
OH20150768363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner