Basic Information
Provider Information
NPI: 1457843237
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CYPHERS
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCARSELLA
OtherFirstName: ASHLEY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 8910 BROAD ST SW
Address2:  
City: PATASKALA
State: OH
PostalCode: 430627886
CountryCode: US
TelephoneNumber: 8663892727
FaxNumber:  
Practice Location
Address1: 8910 BROAD ST SW
Address2:  
City: PATASKALA
State: OH
PostalCode: 430627886
CountryCode: US
TelephoneNumber: 8663892727
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/06/2018
LastUpdateDate: 03/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPRN.CNP.022846OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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