Healthcare Provider Details

I. General information

NPI: 1760328835
Provider Name (Legal Business Name): ASHLEY BEAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 MOUNTAIN ROAD PL NE STE R
ALBUQUERQUE NM
87110-7825
US

IV. Provider business mailing address

203 PASO LLANO DR
RIO RANCHO NM
87124-5018
US

V. Phone/Fax

Practice location:
  • Phone: 480-227-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number57599
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: