Provider Demographics
NPI:1811768732
Name:ASHMUN, DIEDRE DIANE
Entity type:Individual
Prefix:MRS
First Name:DIEDRE
Middle Name:DIANE
Last Name:ASHMUN
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 1:14280 S ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA STATION
Mailing Address - State:OH
Mailing Address - Zip Code:44028-9714
Mailing Address - Country:US
Mailing Address - Phone:216-219-6649
Mailing Address - Fax:
Practice Address - Street 1:14280 S ISLAND RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA STATION
Practice Address - State:OH
Practice Address - Zip Code:44028-9714
Practice Address - Country:US
Practice Address - Phone:216-219-6649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty