Healthcare Provider Details

I. General information

NPI: 1528948080
Provider Name (Legal Business Name): ASHTON H JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N RAMPART BLVD
LAS VEGAS NV
89128-1701
US

IV. Provider business mailing address

4024 LADY FERN AVE
NORTH LAS VEGAS NV
89084-1440
US

V. Phone/Fax

Practice location:
  • Phone: 775-553-8372
  • Fax:
Mailing address:
  • Phone: 435-713-5427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number6766
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: