Basic Information
| Provider Information | |||||||||
| NPI: | 1366112252 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMSTRONG | ||||||||
| FirstName: | ASHTON | ||||||||
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| Credential: | RDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4089 RIVER RD | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713364712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183666643 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1030 JEFFERSON AVE | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381042127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015238990 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2021 | ||||||||
| LastUpdateDate: | 09/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133N00000X | 86145324 | Y | Dietary & Nutritional Service Providers | Nutritionist |
No ID Information.