Provider Demographics
NPI:1801653217
Name:PRUETT, ASHLY N
Entity type:Individual
Prefix:
First Name:ASHLY
Middle Name:N
Last Name:PRUETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLY
Other - Middle Name:N
Other - Last Name:HOSKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 N SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-1748
Mailing Address - Country:US
Mailing Address - Phone:419-604-0253
Mailing Address - Fax:
Practice Address - Street 1:501 N SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-1748
Practice Address - Country:US
Practice Address - Phone:419-604-0253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant