Healthcare Provider Details

I. General information

NPI: 1083407415
Provider Name (Legal Business Name): ASHLEY HARWARD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 N 400 W STE C11
OREM UT
84057-1909
US

IV. Provider business mailing address

1055 N 500 W
PROVO UT
84604-3305
US

V. Phone/Fax

Practice location:
  • Phone: 801-802-7373
  • Fax: 801-802-7733
Mailing address:
  • Phone: 801-354-8225
  • Fax: 801-418-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13600931-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: