Provider Demographics
NPI:1700634342
Name:ECHOLS, ASHLEY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1112
Mailing Address - Street 2:
Mailing Address - City:VILONIA
Mailing Address - State:AR
Mailing Address - Zip Code:72173-1112
Mailing Address - Country:US
Mailing Address - Phone:501-733-3715
Mailing Address - Fax:
Practice Address - Street 1:719 FRONT ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5421
Practice Address - Country:US
Practice Address - Phone:501-900-4549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR085201163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice