Provider Demographics
NPI:1285311548
Name:ASHLEY, JESSICA (NP)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:ASHLEY
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 1:200 PIEDMONT AVE SE STE 1502
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30334-9027
Mailing Address - Country:US
Mailing Address - Phone:734-604-1393
Mailing Address - Fax:
Practice Address - Street 1:200 PIEDMONT AVE SE STE 1502
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30334-9027
Practice Address - Country:US
Practice Address - Phone:734-604-1393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN314613363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily