Provider Demographics
NPI:1255581799
Name:MARTIN, ASHLEY (APRN-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:TOWATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1440 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-1910
Mailing Address - Country:US
Mailing Address - Phone:731-796-6350
Mailing Address - Fax:
Practice Address - Street 1:1201 BISHOP ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5403
Practice Address - Country:US
Practice Address - Phone:731-884-8263
Practice Address - Fax:731-884-8564
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-21
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA212650363LP0808X
TNAPN13632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health