Healthcare Provider Details

I. General information

NPI: 1710530787
Provider Name (Legal Business Name): TRESINA DENISE ASHTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 WALLACE BLVD
AMARILLO TX
79124-2150
US

IV. Provider business mailing address

8601 FOUR ELMS DR
AMARILLO TX
79119-4417
US

V. Phone/Fax

Practice location:
  • Phone: 806-316-1388
  • Fax:
Mailing address:
  • Phone: 806-316-1388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number765127
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: