Individual
ASHLEY RENEE REAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
118 BROWN AVE, STE 103, CROSSVILLE, TN 38555-7739
(931) 484-8861
(931) 456-1319
Mailing address
118 BROWN AVE, STE 103, CROSSVILLE, TN 38555-7739
(931) 484-8861
(931) 456-1319
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2303
TN
363AS0400X
Surgical Physician Assistant
Primary
2303
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q016084
—
TN
Enumeration date
02/19/2013
Last updated
06/24/2020
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