Healthcare Provider Details

I. General information

NPI: 1053856443
Provider Name (Legal Business Name): ASHLEY ANN BAGGOTT ARNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ANN BIBBINS

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 6010
SPOKANE WA
99204-2318
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-5950
  • Fax: 509-838-5961
Mailing address:
  • Phone: 509-474-3568
  • Fax: 509-227-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60739016
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN60708404
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: