Healthcare Provider Details

I. General information

NPI: 1972018067
Provider Name (Legal Business Name): ASHLEY DIANE CARDWELL MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 MAIN AVE
DURANGO CO
81301-5919
US

IV. Provider business mailing address

108 BENNETTSEN CT
BAYFIELD CO
81122-8871
US

V. Phone/Fax

Practice location:
  • Phone: 970-505-2100
  • Fax: 970-259-4403
Mailing address:
  • Phone: 480-444-6076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10833
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number83493
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1000897
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: