Provider Demographics
NPI:1750771770
Name:SKELTON, ASHLEY (NP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:SKELTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 KNOB CREEK RD
Mailing Address - Street 2:SUITE 720
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604
Mailing Address - Country:US
Mailing Address - Phone:423-926-6112
Mailing Address - Fax:423-968-1255
Practice Address - Street 1:2340 KNOB CREEK RD
Practice Address - Street 2:SUITE 720
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-926-6112
Practice Address - Fax:423-968-1255
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000019434363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care