Provider Demographics
NPI:1801146964
Name:BYRD, ASHLEY MICHELLE (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MICHELLE
Last Name:BYRD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-2645
Mailing Address - Country:US
Mailing Address - Phone:563-242-0626
Mailing Address - Fax:563-242-6729
Practice Address - Street 1:1726 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2645
Practice Address - Country:US
Practice Address - Phone:563-242-0626
Practice Address - Fax:563-242-6729
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012025466183500000X
KS1-15028183500000X
IA220881835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care