Provider Demographics
NPI:1831631696
Name:ERNY, ASHTON ELIZABETH (OT)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:ELIZABETH
Last Name:ERNY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ASHTON
Other - Middle Name:E
Other - Last Name:BUMPASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 5629
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5629
Mailing Address - Country:US
Mailing Address - Phone:812-759-7451
Mailing Address - Fax:812-759-7482
Practice Address - Street 1:415 CROSSLAKE DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8263
Practice Address - Country:US
Practice Address - Phone:812-476-0409
Practice Address - Fax:812-476-1016
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006214A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN31006214AOtherLICENSE
IN198850047Medicare PIN
IN31006214AOtherLICENSE
IN216070040Medicare PIN