Provider Demographics
NPI:1740694173
Name:WILLITS, ASHLEY ROSE (RN)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ROSE
Last Name:WILLITS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ROSE
Other - Last Name:MCDANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 107
Mailing Address - Street 2:310 PLUM STREET
Mailing Address - City:MAGNOLIA
Mailing Address - State:OH
Mailing Address - Zip Code:44643
Mailing Address - Country:US
Mailing Address - Phone:330-447-3567
Mailing Address - Fax:
Practice Address - Street 1:310 PLUM STREET
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:OH
Practice Address - Zip Code:44643
Practice Address - Country:US
Practice Address - Phone:330-447-3567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.397176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse