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NPI Code Detail

MEDICARE: MS. ASHLEY ELIZABETH ASHWILL LPN

MEDICARE: MS. ASHLEY ELIZABETH ASHWILL LPN
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
1164W00000XLicensed Practical NurseL0040414OK

General Provider Information

NPI Number : 1609837244
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ASHLEY ELIZABETH ASHWILL LPN
Provider Business Mailing Address
First Line : 5780 S PEORIA AVE
Second Line : PPAEO INC
City : TULSA
State : OK
Zip : 74105-7857
Country : US
Telephone Number : 918-858-5200
Fax Number : 918-582-4921
Provider Business Practice Location Address
First Line : 1007 S PEORIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74120-4495
Country : US
Telephone Number : 918-587-1101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2006
Last Update Date : 07/08/2007

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