Provider Demographics
NPI:1255983821
Name:MCCUEN, ASHLEY BLAIR (ANP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BLAIR
Last Name:MCCUEN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:PIERSANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 SAINT ALBANS DR UNIT 578
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6678
Mailing Address - Country:US
Mailing Address - Phone:215-421-3191
Mailing Address - Fax:
Practice Address - Street 1:4600 SPOTSYLVANIA PKWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7762
Practice Address - Country:US
Practice Address - Phone:540-498-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012782363LA2200X
VA0024177060363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health