Provider Demographics
NPI:1770522617
Name:GUTHRIE, ASHLEY D (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6170 SHALLOWFORD RD
Mailing Address - Street 2:101
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1892
Mailing Address - Country:US
Mailing Address - Phone:423-648-4500
Mailing Address - Fax:423-855-7563
Practice Address - Street 1:403 MCBRIEN RD
Practice Address - Street 2:
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-3223
Practice Address - Country:US
Practice Address - Phone:423-894-3589
Practice Address - Fax:423-892-3378
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008243363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
3928778Medicare ID - Type Unspecified
Q31353Medicare UPIN
1016710001Medicare NSC