Provider Demographics
NPI:1447653076
Name:JONES, ASHLEY NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:JONES
Suffix:
Gender:
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 1:5010 W DAUBER DR
Mailing Address - Street 2:
Mailing Address - City:OTTAWA HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2172
Mailing Address - Country:US
Mailing Address - Phone:419-345-2048
Mailing Address - Fax:800-724-8375
Practice Address - Street 1:5010 W DAUBER DR
Practice Address - Street 2:
Practice Address - City:OTTAWA HILLS
Practice Address - State:OH
Practice Address - Zip Code:43615-2172
Practice Address - Country:US
Practice Address - Phone:419-345-2048
Practice Address - Fax:800-724-8375
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006958RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391959Medicare PIN