Healthcare Provider Details

I. General information

NPI: 1063830404
Provider Name (Legal Business Name): ASHLEY CARAWAY NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

8178 LAUGHING FALCON TRL
CONROE TX
77385-1111
US

V. Phone/Fax

Practice location:
  • Phone: 713-704-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP120335
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP120335
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: