Provider Demographics
NPI:1144870155
Name:HALL, ASHLEY (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BOY SCOUT RD
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-4006
Mailing Address - Country:US
Mailing Address - Phone:304-944-4372
Mailing Address - Fax:304-721-2466
Practice Address - Street 1:64 BOY SCOUT RD
Practice Address - Street 2:
Practice Address - City:HEDGESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25427-4006
Practice Address - Country:US
Practice Address - Phone:304-944-4372
Practice Address - Fax:304-721-2466
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020770P363LF0000X
MDR189448363LF0000X
WV103044363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103687487Medicaid
WV14502396Medicaid