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NPI Code Detail

MEDICARE: TRISTAN ASHFORD

MEDICARE: TRISTAN ASHFORD
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
1363L00000XNurse Practitioner71017444AIN
2163W00000XRegistered Nurse28271707AIN

General Provider Information

NPI Number : 1558237438
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISTAN ASHFORD
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11141 PARKVIEW PLAZA DR STE 320
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1714
Country : US
Telephone Number : 260-425-5400
Fax Number : 260-425-5417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2025
Last Update Date : 02/02/2026

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Directions to “ TRISTAN ASHFORD ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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