Healthcare Provider Details

I. General information

NPI: 1821140559
Provider Name (Legal Business Name): LORI ASHTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 S MOUNTAIN RD
MESA AZ
85212-7005
US

IV. Provider business mailing address

3756 E. LONGHORN STREET
QUEEN CREEK AZ
85242
US

V. Phone/Fax

Practice location:
  • Phone: 480-497-4032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberSN0812
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: