Individual
ASHLEY JENNA KACHIDURIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
12A MIRACLE LN, LOUDONVILLE, NY 12211-2112
(518) 396-8080
Mailing address
12A MIRACLE LN, LOUDONVILLE, NY 12211-2112
(518) 396-8080
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
22641419
NY
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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