Provider Demographics
NPI:1730515925
Name:DARAEI, ASHLEY FOSTER (CPNP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:FOSTER
Last Name:DARAEI
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:FOSTER
Other - Last Name:DARAEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2050 ADAMS OVERLOOK NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1963
Mailing Address - Country:US
Mailing Address - Phone:770-833-8704
Mailing Address - Fax:
Practice Address - Street 1:1975 CENTURY BLVD NE
Practice Address - Street 2:SUITE 6
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3316
Practice Address - Country:US
Practice Address - Phone:404-785-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204891363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics