Doctor Name: | ASHLEY DEGUTIS |
NPI Number: | 1003212382 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 16714 |
Business Practice Address: | 500 Burlington Rd Jackson, OH - 456409360 |
Business Phone Number: | 7403953370 |
Business Fax Number: | 7403958506 |
Mailing Address: | 90 Jackson Pike, GALLIPOLIS |
State: | OH |
Postal Code: | 456311560 |
Phone Number: | 8554465937 |
Fax Number: | 7403958506 |
NPI Enumeration Date: | 11/13/2014 |
NPI Last Update Date: | 02/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 16714 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |