Provider Demographics
NPI:1023784675
Name:SHIVELEY, ASHLEY N
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:SHIVELEY
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 1:109 HOLLY HILL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-1287
Mailing Address - Country:US
Mailing Address - Phone:740-688-9474
Mailing Address - Fax:
Practice Address - Street 1:109 HOLLY HILL DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-1287
Practice Address - Country:US
Practice Address - Phone:740-688-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker