| Doctor Name: | ASHLEY DIVERS |
| NPI Number: | 1023407269 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 19251 |
| Business Practice Address: | 1344 Haile St Camden, SC - 290203076 |
| Business Phone Number: | 8034321996 |
| Business Fax Number: | |
| Mailing Address: | 1344 Haile St, CAMDEN |
| State: | SC |
| Postal Code: | 290203076 |
| Phone Number: | 8034321996 |
| Fax Number: | |
| NPI Enumeration Date: | 01/12/2015 |
| NPI Last Update Date: | 01/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 19251 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |