Ashley Renee Mandeville, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

29948 Issued in WV

Practice address

804 Industrial Park Rd
Maxwelton, WV 24957-8066

Phone

(304) 497-0500

Fax

(304) 497-0516

NPI assigned

Nov 27, 2023

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1891561379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CORAS WAY",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249863086",
            "telephone_number": "304-667-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 INDUSTRIAL PARK RD",
            "city": "MAXWELTON",
            "state": "WV",
            "postal_code": "249578066",
            "telephone_number": "304-497-0500",
            "fax_number": "304-497-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEVILLE",
        "first_name": "ASHLEY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "29948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Kenney
• Kristy Kirk
• Skyler Dawn Lambert
• Wesley Landis
• Courtney Brooke Lindsey
• Samantha Mann
• Ahisha Marshall, BSN,RN
• Richard Lee Martin Jr., CPRS
• Tabatha Sue Martin, LPN
• Tammy Lou Martin

• Licensed Practical Nurse in Maxwelton, WV
• Providers in Maxwelton, WV by specialty
• Licensed Practical Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.