Provider Demographics
NPI:1942719216
Name:PARKER, ASHLY ANN ROBY (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLY
Middle Name:ANN ROBY
Last Name:PARKER
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 1:39 SKIHI ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-3413
Mailing Address - Country:US
Mailing Address - Phone:931-206-7455
Mailing Address - Fax:
Practice Address - Street 1:600 MT HIGHWAY 91 S
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-7379
Practice Address - Country:US
Practice Address - Phone:406-683-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-58470207P00000X, 207Q00000X, 207R00000X, 208M00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1143430OtherNCCPA
MTMED-PAC-LIC-58470OtherMONTANA STATE MEDICAL BOARD