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General NPI Number Information
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NPI Number | 1336323005
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Entity Type | Individual
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Provider Name | KENDALLYN ASHLEY FNP
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Gender | Female
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 4212 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85016-5319
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Country | US
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Telephone | 602-263-1200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95460
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City | CLEVELAND
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State | OH
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Zip | 44101-0033
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Country | US
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Telephone | 602-263-1200
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Fax | 602-263-1619
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN141178
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP 9639
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License Number State | AZ
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