Provider Demographics
NPI:1457744914
Name:ANDERSON, ASHLEY LAUREN (RN)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:LAUREN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 LITTLE AMSTERDAM RD
Mailing Address - Street 2:PO BOX 87
Mailing Address - City:WELLS
Mailing Address - State:NY
Mailing Address - Zip Code:12190
Mailing Address - Country:US
Mailing Address - Phone:518-332-1182
Mailing Address - Fax:
Practice Address - Street 1:1466 COUNTY ROUTE 29
Practice Address - Street 2:
Practice Address - City:OLMSTEDVILLE
Practice Address - State:NY
Practice Address - Zip Code:12857
Practice Address - Country:US
Practice Address - Phone:518-251-2000
Practice Address - Fax:518-251-2395
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY660395163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool