Healthcare Provider Details

I. General information

NPI: 1013864305
Provider Name (Legal Business Name): MICHELLE ASHLEY COUTURE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2026
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 TESORI DR
PALM DESERT CA
92211-0799
US

IV. Provider business mailing address

110 TESORI DR
PALM DESERT CA
92211-0799
US

V. Phone/Fax

Practice location:
  • Phone: 714-454-1116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: