Healthcare Provider Details

I. General information

NPI: 1962287771
Provider Name (Legal Business Name): ASHLEY TARYN FROMM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY TARYN MONTGOMERY RN

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 E MCDOWELL RD FL 3
PHOENIX AZ
85006-2506
US

IV. Provider business mailing address

5631 E HARTFORD AVE
SCOTTSDALE AZ
85254-5966
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-3300
  • Fax:
Mailing address:
  • Phone: 480-678-2142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number267069
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number267069
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: