Healthcare Provider Details

I. General information

NPI: 1184178089
Provider Name (Legal Business Name): ASHLEY GISH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 SANTA MONICA BLVD FL 2
WEST HOLLYWOOD CA
90069-4496
US

IV. Provider business mailing address

8550 SANTA MONICA BLVD FL 2
WEST HOLLYWOOD CA
90069-4496
US

V. Phone/Fax

Practice location:
  • Phone: 909-962-1260
  • Fax:
Mailing address:
  • Phone: 909-962-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1110778
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number8044150-4405APRN
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number11017
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421639
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number291753
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberTPAN1587
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number201607536NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: