Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN2270212 | MA |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN2270212 | MA |
NPI | 1003248600 |
---|---|
Provider Name | Ms. Ashley Renee Mcinnis |
First Address | Plymouth, MA 02360-7243 |
Second Address | Plymouth, MA 02360-7243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2013 |
Last Update Date | 02/02/2022 |