Provider Demographics
NPI:1922456839
Name:WENCE, ASHLEY BENNETT (APRN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BENNETT
Last Name:WENCE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MICHELLE
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 743294
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3294
Mailing Address - Country:US
Mailing Address - Phone:864-295-2131
Mailing Address - Fax:864-269-8039
Practice Address - Street 1:52 BEAR DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4458
Practice Address - Country:US
Practice Address - Phone:864-295-2131
Practice Address - Fax:864-269-8035
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC216207163W00000X
SC20318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3983Medicaid
SCP01772172OtherRAILROAD MEDICARE
SCP01772172OtherRAILROAD MEDICARE
SCNP3983Medicaid