Provider Demographics
NPI:1205101391
Name:ASHBY, MONA-LISA (RN)
Entity type:Individual
Prefix:MS
First Name:MONA-LISA
Middle Name:
Last Name:ASHBY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MONA-LISA
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7508 BAYLOR WAY CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-6708
Mailing Address - Country:US
Mailing Address - Phone:704-208-7284
Mailing Address - Fax:980-226-5341
Practice Address - Street 1:7508 BAYLOR WAY CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-6708
Practice Address - Country:US
Practice Address - Phone:704-208-7284
Practice Address - Fax:980-226-5341
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC154238163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical