Basic Information
Provider Information
NPI: 1568950830
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRESNELL
FirstName: ASHLEY
MiddleName: CAUBLE
NamePrefix:  
NameSuffix:  
Credential: AGPCNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 281
Address2:  
City: WENTWORTH
State: NC
PostalCode: 273750281
CountryCode: US
TelephoneNumber: 3364279022
FaxNumber: 3366427903
Practice Location
Address1: 2150 NC HIGHWAY 65
Address2:  
City: REIDSVILLE
State: NC
PostalCode: 273209609
CountryCode: US
TelephoneNumber: 3364279022
FaxNumber: 3364279030
Other Information
ProviderEnumerationDate: 04/23/2018
LastUpdateDate: 05/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X5010770NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LA2200X5010770NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
363LP2300X5010770NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
363LG0600X5010770NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology

No ID Information.


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