Healthcare Provider Details

I. General information

NPI: 1043978653
Provider Name (Legal Business Name): ASHLEIGH MARIE PICKARD RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 12/01/2021
Certification Date: 11/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 W 15TH ST STE 1025
PLANO TX
75075-7253
US

IV. Provider business mailing address

870 BLASSINGAME AVE APT 6103
VAN ALSTYNE TX
75495-2855
US

V. Phone/Fax

Practice location:
  • Phone: 972-673-0404
  • Fax:
Mailing address:
  • Phone: 469-644-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number983937
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number983937
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number983937
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: