Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0024170278 | VA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 0024170278 | VA |
NPI | 1174871529 |
---|---|
Provider Name | Ms. Ashley Michelle Leech Frese |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-3300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2012 |
Last Update Date | 19/07/2021 |