Provider Demographics
NPI:1164246880
Name:DAHL, ASHLEY LUCILLE (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LUCILLE
Last Name:DAHL
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1011 MONTGOMERY AVE APT R
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2843
Mailing Address - Country:US
Mailing Address - Phone:325-716-9643
Mailing Address - Fax:
Practice Address - Street 1:507 KIMBERTON RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4745
Practice Address - Country:US
Practice Address - Phone:610-243-9117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA065889363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant