Provider Demographics
NPI:1023077997
Name:DEVRIES, ASHLEY BETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:BETH
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:D
Other - Last Name:MCCLELLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5431 HOPETOWN LN
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32408-7938
Mailing Address - Country:US
Mailing Address - Phone:850-832-8923
Mailing Address - Fax:850-785-1066
Practice Address - Street 1:114 AIRPORT RD STE B
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4738
Practice Address - Country:US
Practice Address - Phone:850-785-0788
Practice Address - Fax:850-785-1066
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9103557363AM0700X
FLPA9103557363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant