Provider Demographics
NPI:1730929258
Name:ASHNAULT, DANNICA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:DANNICA
Middle Name:LYNN
Last Name:ASHNAULT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8397 S SHORE RD
Mailing Address - Street 2:
Mailing Address - City:SODUS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:14555-9513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8397 S SHORE RD
Practice Address - Street 2:
Practice Address - City:SODUS POINT
Practice Address - State:NY
Practice Address - Zip Code:14555-9513
Practice Address - Country:US
Practice Address - Phone:845-216-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant