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General NPI Number Information
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NPI Number | 1124744396
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Entity Type | Individual
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Provider Name | ASHLEY MCKENDALL NP
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Gender | Female
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 148 W BASELINE RD.
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City | MESA
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State | AZ
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Zip | 85210
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Country | US
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Telephone | 480-559-3149
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Fax |
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Provider Business Mailing Address
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Address Line | 6219 W ALTADENA AVE
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City | GLENDALE
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State | AZ
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Zip | 85304-3203
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Country | US
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Telephone | 808-673-0171
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number | RN210369
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 291628
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License Number State | AZ
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