Provider Demographics
NPI:1265047385
Name:ASHLEY-MAYS, ERICA NICOLE
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:NICOLE
Last Name:ASHLEY-MAYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 SHILOH RD NW
Mailing Address - Street 2:APT 805
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6465
Mailing Address - Country:US
Mailing Address - Phone:404-704-5966
Mailing Address - Fax:
Practice Address - Street 1:1750 SHILOH RD NW
Practice Address - Street 2:APT 805
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6465
Practice Address - Country:US
Practice Address - Phone:404-704-5966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider