Provider Demographics
NPI:1841339066
Name:HOUSE, ASHLEY R (PA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:R
Last Name:HOUSE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 CRUTCHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2726
Mailing Address - Country:US
Mailing Address - Phone:919-470-7000
Mailing Address - Fax:919-470-7028
Practice Address - Street 1:407 CRUTCHFIELD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2726
Practice Address - Country:US
Practice Address - Phone:919-470-7000
Practice Address - Fax:919-470-7028
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02395363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical