Provider Demographics
NPI:1982382040
Name:CISCO, ASHLEY NICOLE (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:CISCO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45656-0036
Mailing Address - Country:US
Mailing Address - Phone:740-418-9983
Mailing Address - Fax:
Practice Address - Street 1:6149 STATE ROUTE 93
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:OH
Practice Address - Zip Code:45656-9360
Practice Address - Country:US
Practice Address - Phone:740-418-9983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide