Healthcare Provider Details

I. General information

NPI: 1053862078
Provider Name (Legal Business Name): ASHLEY M MORELLO AGACNP-BC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY MARGARET SMYERS AGACNP-BC, RN

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSAL PAIN MANAGEMENT 16179 SISKIYOU
APPLE VALLEY CA
92307
US

IV. Provider business mailing address

11082 MOKI RD
APPLE VALLEY CA
92308-9435
US

V. Phone/Fax

Practice location:
  • Phone: 760-241-0350
  • Fax: 760-243-0738
Mailing address:
  • Phone: 909-856-8541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1086176
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1086176
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95005621
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number261925
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN03229
License Number StateRI
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number261925
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number799701
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN73832
License Number StateRI
# 9
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN72086
License Number StateNV
# 10
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNV847617
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: