Provider Demographics
NPI:1053000950
Name:HAGOOD, ASHLEY MARIAH (BSN, RN)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:MARIAH
Last Name:HAGOOD
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10825 E KESWICK RD APT 5
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-4129
Mailing Address - Country:US
Mailing Address - Phone:267-535-9070
Mailing Address - Fax:
Practice Address - Street 1:10825 E KESWICK RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-4134
Practice Address - Country:US
Practice Address - Phone:267-535-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN651244163WC1600X, 163WH0200X, 163W00000X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy