Provider Demographics
NPI:1861991671
Name:DICKEY, ASHLEY MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:DICKEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3279 HIGHWAY 364
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-8541
Mailing Address - Country:US
Mailing Address - Phone:870-931-8726
Mailing Address - Fax:
Practice Address - Street 1:505 E MATTHEWS AVE STE 303
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3101
Practice Address - Country:US
Practice Address - Phone:870-932-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017449367500000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program