Basic Information
| Provider Information | |||||||||
| NPI: | 1457021651 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARKER | ||||||||
| FirstName: | ASHLYN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | DNP, CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 613 CRESTVIEW CT | ||||||||
| Address2: | |||||||||
| City: | LONGS | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295685600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2252767206 | ||||||||
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| Practice Location | |||||||||
| Address1: | 809 82ND PKWY | ||||||||
| Address2: | |||||||||
| City: | MYRTLE BEACH | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295724607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436921000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2021 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 25721 | SC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163WC0200X | 906942 | TX | Y | Nursing Service Providers | Registered Nurse | Critical Care Medicine |
No ID Information.