Provider Demographics
NPI:1750737748
Name:CRATCH, ASHLEY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:CRATCH
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:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28502-0674
Mailing Address - Country:US
Mailing Address - Phone:252-208-8479
Mailing Address - Fax:252-686-8808
Practice Address - Street 1:1002 WESTMINSTER LN
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-2766
Practice Address - Country:US
Practice Address - Phone:252-208-8479
Practice Address - Fax:252-686-8808
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376G00000X
NCFCL054072376K00000X, 374U00000X
NC376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No376G00000XNursing Service Related ProvidersNursing Home Administrator
No374U00000XNursing Service Related ProvidersHome Health Aide