Provider Demographics
NPI:1649023995
Name:THORUP, ASHLEY RENEA (CPM, LLM)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEA
Last Name:THORUP
Suffix:
Gender:F
Credentials:CPM, LLM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 N TIMELESS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-7638
Mailing Address - Country:US
Mailing Address - Phone:479-883-6499
Mailing Address - Fax:
Practice Address - Street 1:544 N TIMELESS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-7638
Practice Address - Country:US
Practice Address - Phone:479-883-6499
Practice Address - Fax:479-765-1983
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
No176B00000XOther Service ProvidersMidwife