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NPI Code Detail

MEDICARE: ASHLEY BENALLY-ROSS PMHNP-BC

MEDICARE: ASHLEY BENALLY-ROSS PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LC1500XCommunity Health Nurse PractitionerAPN0995613CO
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPN.0995613-NPCO

General Provider Information

NPI Number : 1073121943
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY BENALLY-ROSS PMHNP-BC
Provider Business Mailing Address
First Line : 3449 VAUGHN VIEW DR
Second Line :
City : PUEBLO
State : CO
Zip : 81005-9750
Country : US
Telephone Number : 719-417-5754
Fax Number : 719-888-1655
Provider Business Practice Location Address
First Line : 5353 N UNION BLVD STE 202
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-2069
Country : US
Telephone Number : 970-310-3406
Fax Number : 888-965-4615
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2020
Last Update Date : 01/15/2026

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Directions to “ ASHLEY BENALLY-ROSS PMHNP-BC” Practice Location

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