Provider Demographics
NPI:1902353170
Name:SPEARS, ASHLEY NICHOLE (CSFA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICHOLE
Last Name:SPEARS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4181 HOSPITAL DR NE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2541
Mailing Address - Country:US
Mailing Address - Phone:770-385-8954
Mailing Address - Fax:770-385-8590
Practice Address - Street 1:4181 HOSPITAL DR NE
Practice Address - Street 2:SUITE 104
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2541
Practice Address - Country:US
Practice Address - Phone:770-385-8954
Practice Address - Fax:770-385-8590
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant