Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 402571 | NY |
NPI | 1033775408 |
---|---|
Provider Name | Ashley Michelle Price |
First Address | Whitesboro, NY 13492-1013 |
Second Address | Syracuse, NY 13204-2457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2019 |
Last Update Date | 11/05/2019 |