Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 0024173761 | VA |
NPI | 1205380805 |
---|---|
Provider Name | Mrs. Ashley Nicole Whitlow |
First Address | Roanoke, VA 24019-3817 |
Second Address | Roanoke, VA 24014-1838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2016 |
Last Update Date | 11/08/2016 |