Provider Demographics
NPI:1700258399
Name:HARRIS, ASHLEY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 LIVINGSTON RD SE
Mailing Address - Street 2:APT. B
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2938
Mailing Address - Country:US
Mailing Address - Phone:202-644-0771
Mailing Address - Fax:
Practice Address - Street 1:4402 LIVINGSTON RD SE
Practice Address - Street 2:APT. B
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2938
Practice Address - Country:US
Practice Address - Phone:202-644-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11464374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide