Provider Demographics
NPI:1831241397
Name:ASHLEY, PEGGY ANNE (CRNA)
Entity type:Individual
Prefix:MISS
First Name:PEGGY
Middle Name:ANNE
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17706 PRESCOTT BORDER DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8761
Mailing Address - Country:US
Mailing Address - Phone:704-895-8885
Mailing Address - Fax:
Practice Address - Street 1:17706 PRESCOTT BORDER DR
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8761
Practice Address - Country:US
Practice Address - Phone:704-895-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC051443163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered