Provider Demographics
NPI:1205510542
Name:MINES, ASHLEY LA-CORA (RN,BSN)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:LA-CORA
Last Name:MINES
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1688 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-3467
Mailing Address - Country:US
Mailing Address - Phone:216-889-7081
Mailing Address - Fax:
Practice Address - Street 1:1688 E 82ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3467
Practice Address - Country:US
Practice Address - Phone:216-889-7081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH499357163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse