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Individual

KENNETH E ASHLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
8001 YOUREE DR, SHREVEPORT, LA 71115-2302
(318) 212-3000
Mailing address
207 BAY HILLS DR, BENTON, LA 71006-9455
(318) 965-5586

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN077546
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1988758
LA
Enumeration date
11/09/2005
Last updated
07/31/2008
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