Provider Demographics
NPI:1053768390
Name:CRAYTON, ASHLEY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:CRAYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 ELYSIAN FIELDS AVE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4245
Mailing Address - Country:US
Mailing Address - Phone:504-301-1145
Mailing Address - Fax:504-373-5724
Practice Address - Street 1:6305 ELYSIAN FIELDS AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-4245
Practice Address - Country:US
Practice Address - Phone:504-301-1145
Practice Address - Fax:504-373-5724
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA007382687343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA274636732Other274636732