Basic Information
Provider Information
NPI: 1831573369
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIELDS
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 10000 W 75TH ST STE 250
Address2:  
City: MERRIAM
State: KS
PostalCode: 662042218
CountryCode: US
TelephoneNumber: 8889131910
FaxNumber: 8779131174
Practice Location
Address1: 10000 W 75TH ST STE 250
Address2:  
City: MERRIAM
State: KS
PostalCode: 662042218
CountryCode: US
TelephoneNumber: 8889131910
FaxNumber: 8779131174
Other Information
ProviderEnumerationDate: 07/14/2015
LastUpdateDate: 03/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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