Healthcare Provider Details

I. General information

NPI: 1497624183
Provider Name (Legal Business Name): ANDREW KYLE ASHLEY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 W AMARILLO BLVD
AMARILLO TX
79106-1990
US

IV. Provider business mailing address

6600 PLUM CREEK DR APT 115
AMARILLO TX
79124-1614
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-9703
  • Fax:
Mailing address:
  • Phone: 806-355-9703
  • Fax: 806-468-1807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1119330
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: