Healthcare Provider Details

I. General information

NPI: 1427598366
Provider Name (Legal Business Name): ASHLEY ARTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2017
Last Update Date: 02/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 CHALAN SAN ANTONIO STE 1
TAMUNING GU
96913-3620
US

IV. Provider business mailing address

PO BOX 23052
BARRIGADA GU
96921-3052
US

V. Phone/Fax

Practice location:
  • Phone: 671-482-3643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP0161
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: