Provider Demographics
NPI:1700401817
Name:PSENICKA, ASHLEE ANNE
Entity Type:Individual
Prefix:MRS
First Name:ASHLEE
Middle Name:ANNE
Last Name:PSENICKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 1/2 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2124
Mailing Address - Country:US
Mailing Address - Phone:717-984-0715
Mailing Address - Fax:
Practice Address - Street 1:719 1/2 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2124
Practice Address - Country:US
Practice Address - Phone:717-984-0715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty