Provider Demographics
NPI:1023724390
Name:WHITENACK, ASHLI NICOLE
Entity type:Individual
Prefix:
First Name:ASHLI
Middle Name:NICOLE
Last Name:WHITENACK
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:ASHLI WHITENACK
Mailing Address - Street 2:685 TURNER RD.
Mailing Address - City:LYNCHBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45142-9756
Mailing Address - Country:US
Mailing Address - Phone:513-346-0545
Mailing Address - Fax:
Practice Address - Street 1:880 TURNER RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:OH
Practice Address - Zip Code:45142-9630
Practice Address - Country:US
Practice Address - Phone:937-515-4992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH108683444599Medicaid