Provider Demographics
NPI:1295157576
Name:CHAMBLEE, ASHTON SALEEBY (PA-C)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:SALEEBY
Last Name:CHAMBLEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 RANDOLPH RD 600
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1198
Mailing Address - Country:US
Mailing Address - Phone:704-926-5540
Mailing Address - Fax:704-926-5551
Practice Address - Street 1:1918 RANDOLPH RD 600
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1198
Practice Address - Country:US
Practice Address - Phone:704-926-5540
Practice Address - Fax:704-926-5551
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04747363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant