Provider Demographics
NPI:1942452511
Name:SCHAEFER, ASHLEY E (NP)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:E
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-1400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:950 MAIN ST
Practice Address - Street 2:CLARK UNIVERSITY HEALTH SERVICES
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1400
Practice Address - Country:US
Practice Address - Phone:508-793-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2022-11-02
Deactivation Date:2021-07-21
Deactivation Code:
Reactivation Date:2021-08-06
Provider Licenses
StateLicense IDTaxonomies
MA266774363L00000X
CT003963363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0719625Medicaid
MA0719625Medicaid