Individual
ELESHIA STEPHENIE AMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
60 BRYAN BLVD, CORBIN, KY 40701-2779
(606) 528-1172
Mailing address
343 HARNESS RD, LONDON, KY 40744-8874
(606) 312-6989
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100727050
—
KY
Enumeration date
09/10/2020
Last updated
09/12/2023
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