Provider Demographics
NPI:1619392917
Name:BORDERS, ASHLEY SHAKISTYA
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHAKISTYA
Last Name:BORDERS
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 1:767 GRAVES ST
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-8515
Mailing Address - Country:US
Mailing Address - Phone:863-440-3442
Mailing Address - Fax:
Practice Address - Street 1:767 GRAVES ST
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-8515
Practice Address - Country:US
Practice Address - Phone:863-440-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-23
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health