Healthcare Provider Details

I. General information

NPI: 1548713472
Provider Name (Legal Business Name): ASHLEY A BUTTON FNP-BC, MSN, RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 10/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 SAN MATEO BLVD SE
ALBUQUERQUE NM
87108-2921
US

IV. Provider business mailing address

PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-462-7333
  • Fax: 505-462-7301
Mailing address:
  • Phone: 505-923-6770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-02985
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: