Provider Demographics
NPI:1841533379
Name:DELOATCH, ASHLEY F (FNP-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:F
Last Name:DELOATCH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:114 HOLLOWELL ROAD
Mailing Address - City:AULANDER
Mailing Address - State:NC
Mailing Address - Zip Code:27805-0309
Mailing Address - Country:US
Mailing Address - Phone:252-345-3791
Mailing Address - Fax:252-345-0480
Practice Address - Street 1:114 HOLLOWELL ROAD
Practice Address - Street 2:
Practice Address - City:AULANDER
Practice Address - State:NC
Practice Address - Zip Code:27805-0309
Practice Address - Country:US
Practice Address - Phone:252-345-3791
Practice Address - Fax:252-345-0480
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006121363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner