Provider Demographics
NPI:1710799077
Name:GREENE, ASHLEY A
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:GREENE
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 1:1502 SOUTHPARK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-7489
Mailing Address - Country:US
Mailing Address - Phone:608-322-1199
Mailing Address - Fax:
Practice Address - Street 1:1502 SOUTHPARK CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-7489
Practice Address - Country:US
Practice Address - Phone:608-322-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management