Provider Demographics
NPI:1982121299
Name:RIDDICK, ASHLEE THRASHER (DNP, CRNA)
Entity Type:Individual
Prefix:DR
First Name:ASHLEE
Middle Name:THRASHER
Last Name:RIDDICK
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 ORKNEY RD
Mailing Address - Street 2:
Mailing Address - City:STEM
Mailing Address - State:NC
Mailing Address - Zip Code:27581-9132
Mailing Address - Country:US
Mailing Address - Phone:301-471-2003
Mailing Address - Fax:
Practice Address - Street 1:3643 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2702
Practice Address - Country:US
Practice Address - Phone:919-470-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113605367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered