Provider Demographics
NPI:1942898036
Name:BARNES, ASHLEY KATHLEEN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KATHLEEN
Last Name:BARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 BROMAN WAY
Mailing Address - Street 2:
Mailing Address - City:LYNDEBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03082-5900
Mailing Address - Country:US
Mailing Address - Phone:603-721-2780
Mailing Address - Fax:
Practice Address - Street 1:39 BROMAN WAY
Practice Address - Street 2:
Practice Address - City:LYNDEBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03082-5900
Practice Address - Country:US
Practice Address - Phone:603-721-2780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VT055.0031609363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program