Provider Demographics
NPI:1174153951
Name:BAKER CALHOUN, ASHLEY (CNA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BAKER CALHOUN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86129 PALM TREE DR
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-3966
Mailing Address - Country:US
Mailing Address - Phone:904-335-1246
Mailing Address - Fax:
Practice Address - Street 1:86129 PALM TREE DR
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-3966
Practice Address - Country:US
Practice Address - Phone:912-467-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA377714251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health