Healthcare Provider Details

I. General information

NPI: 1831632991
Provider Name (Legal Business Name): ASHLEY GREENE LONG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY MARIE GREENE NP

II. Dates (important events)

Enumeration Date: 11/22/2016
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 S DOWNING ST STE 380
DENVER CO
80210-5850
US

IV. Provider business mailing address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-5797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0992616
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0992616-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: