| NPI | 1225506207 |
|---|---|
| Former Name | ASHLEY NICHOLE SPARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2467) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY PA2467) |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA2467) | |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2024-05-21 |