Ashley Dillon, NP

Individual provider Active NPI Family Nurse Practitioner · Gloster, MS

NPI 1861862963 · NPPES record last updated Nov 14, 2023

Key facts

NPI
1861862963
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
R878172 (MS)
Practice address
434 N Captain Gloster Dr
Gloster, MS 39638-3401
Phone
(601) 225-4711
Fax
(601) 225-4144
NPI assigned
Oct 1, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160321001370 MS Practitioner - Nurse Practitioner 7214234137

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R878172MSMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R878172 MS Yes

Addresses

Primary practice location

434 N Captain Gloster Dr
Gloster, MS 39638-3401

Mailing address

434 N Captain Gloster Dr
Gloster, MS 39638-3401
Phone (601) 225-4711

Other providers in Gloster, MS

All providers in Gloster, MS · Family Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.