Provider Demographics
NPI:1205729274
Name:ASHLEY, CHANEL MONIQUE
Entity type:Individual
Prefix:
First Name:CHANEL
Middle Name:MONIQUE
Last Name:ASHLEY
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 1:2328 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-3971
Mailing Address - Country:US
Mailing Address - Phone:269-569-4972
Mailing Address - Fax:
Practice Address - Street 1:2328 NEWTON ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3971
Practice Address - Country:US
Practice Address - Phone:269-569-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322275150621376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide