Provider Demographics
NPI:1922344019
Name:DRIVER, ASHLEY LUEBBERS (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LUEBBERS
Last Name:DRIVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:LUEBBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13436 GREEN ORCHARD CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-7905
Mailing Address - Country:US
Mailing Address - Phone:804-530-1903
Mailing Address - Fax:
Practice Address - Street 1:13436 GREEN ORCHARD CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-7905
Practice Address - Country:US
Practice Address - Phone:804-399-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1045030133V00000X
VA390200000X
VA0110006709363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program