ASHLEIGH DERISO (NPI# 1003064734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003064734 |
| Entity Type | Individual |
| Full Name | ASHLEIGH DERISO |
| Practice Address |
1727 Wrightsboro Rd Suite B Augusta GA 30904-4074 |
| Mailing Address |
7377 Clarks Mill Rd Louisville GA 30434-4102 |
| Practice Telephone | 7067368170 |
| Practice Fax Number | 7067368184 |
| Mailing Telephone | 7066994585 |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2008-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 075313 | GA | Nursing Service Providers |
| Street Address |
1727 WRIGHTSBORO RD SUITE B |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-4074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780669218 | Mary Lynn Tyson | Psychiatry & Neurology | 1727 Wrightsboro Rd, Suite B, Augusta, GA 30904-4074 | 2005-12-07 |
| 1639635873 | Jacquelina Deanna Pickett | Social Worker | 1727 Wrightsboro Rd, Augusta, GA 30904-4049 | 2019-02-12 |
| 1750847190 | Amy Michelle Anderson | Registered Nurse | 1727 Wrightsboro Rd, Augusta, GA 30904-4049 | 2019-02-11 |
| 1114383551 | Ronda Taylor | Counselor | 1727 Wrightsboro Rd, Suite A, Augusta, GA 30904-4049 | 2016-01-14 |
| 1619343456 | Nicole Goudelock | Counselor | 1727 Wrightsboro Rd, Augusta, GA 30904-4049 | 2015-08-17 |
| 1932494960 | Megan Sarah Paul | Counselor | 1727 Wrightsboro Rd, Suite B, Augusta, GA 30904-4074 | 2011-06-17 |
| 1508014168 | Laron Freeman | Social Worker | 1727 Wrightsboro Rd, Suite B, Augusta, GA 30904-4074 | 2008-09-08 |
| 1326296146 | Pam Oliphant | Social Worker | 1727 Wrightsboro Rd, Augusta, GA 30904-4074 | 2008-09-04 |
| 1396993119 | Denny Brown | Social Worker | 1727 Wrightsboro Rd, Augusta, GA 30904-4074 | 2008-09-04 |
| 1285882001 | Samuel Leverett | Social Worker | 1727 Wrightsboro Rd, Suite B, Augusta, GA 30904-4074 | 2008-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730709866 | Michelle Gonzalez | Licensed Practical Nurse | 7906 N 39th St, Augusta, MI 49012-9714 | 2020-04-18 |
| 1104215565 | Valerie Louise Potter | Licensed Practical Nurse | 4928 Ford Hill Road, Augusta, WV 26704 | 2015-01-22 |
| 1407129448 | Kimberly R Garcia | Licensed Practical Nurse | 3902 Creekwood Ln, Augusta, GA 30907-2422 | 2012-02-22 |
| 1144593906 | Terence Alan Dunavan | Licensed Practical Nurse | 1506 Pendleton Rd, Augusta, GA 30904-4840 | 2012-02-09 |
| 1861790891 | Tina Maria Mays | Licensed Practical Nurse | Hc 71 Box 115m, Augusta, WV 26704 | 2011-02-28 |
| 1922235076 | Day Break Medical Resource Group | Licensed Practical Nurse | 4349 White Pine Ct, Augusta, GA 30906-8122 | 2009-06-16 |
| 1841448024 | Kenya Cook Jones | Licensed Practical Nurse | 1 Freedom Way # 5, Augusta, GA 30904-6258 | 2008-08-31 |
| 1760654826 | Shirlene Demetra Williams | Licensed Practical Nurse | 2545 Sandra Dr, Augusta, GA 30906-2843 | 2008-03-29 |
| 1861697187 | Kendra Celeste Cunningham | Licensed Practical Nurse | 1243 Pine St, Augusta, GA 30901-3334 | 2007-06-18 |
| 1053498550 | Arnita F. Thomas | Licensed Practical Nurse | 2420 Windsor Spring Rd, Augusta, GA 30906-4668 | 2006-11-01 |
| Find all providers in AUGUSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.