Healthcare Provider Details

I. General information

NPI: 1366961708
Provider Name (Legal Business Name): ASHLEY ANN NUNLEY LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY ANN NUNLEY

II. Dates (important events)

Enumeration Date: 09/18/2017
Last Update Date: 09/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 PINON ST
SANTA FE NM
87505-3454
US

IV. Provider business mailing address

1886 CALLE QUEDO APT B
SANTA FE NM
87505-5899
US

V. Phone/Fax

Practice location:
  • Phone: 512-815-6837
  • Fax:
Mailing address:
  • Phone: 512-815-6837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number8324
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: