Provider Demographics
NPI:1255020657
Name:PETERS, ASHLYN NICOLE
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:NICOLE
Last Name:PETERS
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 1:1100 SANDYSTONE RD APT K
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-4517
Mailing Address - Country:US
Mailing Address - Phone:301-305-5597
Mailing Address - Fax:
Practice Address - Street 1:1100 SANDYSTONE RD APT K
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-4517
Practice Address - Country:US
Practice Address - Phone:301-305-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula