Individual
MRS. ASHLEY LACEY BOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8 LIVE OAK CT, MOULTRIE, GA 31768-6783
(229) 890-6612
Mailing address
PO BOX 2876, MOULTRIE, GA 31776-2876
(229) 890-6612
(229) 890-6621
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN181134
GA
Other
Enumeration date
11/01/2012
Last updated
09/08/2025
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