Provider Demographics
NPI:1841727856
Name:VETTESE, ASHLEE LYNN
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:LYNN
Last Name:VETTESE
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 1:1734 MARLTON PIKE E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2307
Mailing Address - Country:US
Mailing Address - Phone:856-797-0202
Mailing Address - Fax:856-721-7700
Practice Address - Street 1:1734 MARLTON PIKE E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2307
Practice Address - Country:US
Practice Address - Phone:856-797-0202
Practice Address - Fax:856-751-7700
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2019-05-07
Deactivation Date:2017-12-05
Deactivation Code:
Reactivation Date:2019-05-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical