Basic Information
Provider Information
NPI: 1336620269
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CANNADY
FirstName: ASHLEY
MiddleName: E
NamePrefix: MRS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1720 NICHOLASVILLE RD STE 702
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405031489
CountryCode: US
TelephoneNumber: 8592648811
FaxNumber: 8592648822
Practice Location
Address1: 1720 NICHOLASVILLE RD STE 702
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405031489
CountryCode: US
TelephoneNumber: 8592648811
FaxNumber: 8592648822
Other Information
ProviderEnumerationDate: 08/28/2018
LastUpdateDate: 02/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X3012635KYN Allopathic & Osteopathic PhysiciansFamily Medicine 
363LF0000X3012635KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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