Provider Demographics
NPI:1013673797
Name:POWELL, ASHLEE J (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:J
Last Name:POWELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 PENNSYLVANIA AVE UPPR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-6046
Mailing Address - Country:US
Mailing Address - Phone:585-285-9118
Mailing Address - Fax:
Practice Address - Street 1:185 PENNSYLVANIA AVE UPPR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-6046
Practice Address - Country:US
Practice Address - Phone:585-285-9118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342844164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty