Provider Demographics
NPI:1942893623
Name:ADE, ASHLEY R (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:R
Last Name:ADE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3577
Mailing Address - Country:US
Mailing Address - Phone:706-372-1405
Mailing Address - Fax:
Practice Address - Street 1:240 MITCHELL BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2043
Practice Address - Country:US
Practice Address - Phone:706-369-5745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-14
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN286396163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty