Provider Demographics
NPI:1518613850
Name:HIXSON, ASHLEY E (RN,BSN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:E
Last Name:HIXSON
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:E
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 W VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-1908
Mailing Address - Country:US
Mailing Address - Phone:708-477-7501
Mailing Address - Fax:
Practice Address - Street 1:215 W VERMONT ST
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-1908
Practice Address - Country:US
Practice Address - Phone:708-477-7501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041405835163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty