Provider Demographics
NPI:1740893403
Name:ASH, DIANNE KAY
Entity type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:KAY
Last Name:ASH
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DIANNE
Other - Middle Name:KAY
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1130 14TH ST APT 417
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-4066
Mailing Address - Country:US
Mailing Address - Phone:727-215-5803
Mailing Address - Fax:
Practice Address - Street 1:2901 5TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1407
Practice Address - Country:US
Practice Address - Phone:304-697-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program