Basic Information
Provider Information
NPI: 1497889323
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASH
FirstName: MARIA
MiddleName: R
NamePrefix: MRS.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 104 JADE DR
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198102251
CountryCode: US
TelephoneNumber: 3024756631
FaxNumber:  
Practice Location
Address1: 300 EVERGREEN DR
Address2: SUITE 310
City: GLEN MILLS
State: PA
PostalCode: 193421059
CountryCode: US
TelephoneNumber: 6105793564
FaxNumber: 6105793555
Other Information
ProviderEnumerationDate: 03/15/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC0200XSP008060PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine

No ID Information.


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