Provider Demographics
NPI:1366996951
Name:PAGADUAN, ASHLEIGH LYNN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:ASHLEIGH
Middle Name:LYNN
Last Name:PAGADUAN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2847
Mailing Address - Country:US
Mailing Address - Phone:757-395-1700
Mailing Address - Fax:757-507-9004
Practice Address - Street 1:3745 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2847
Practice Address - Country:US
Practice Address - Phone:757-395-1700
Practice Address - Fax:757-507-9004
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-005490363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant