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General NPI Number Information
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NPI Number | 1740703917
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Entity Type | Individual
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Provider Name | ASHLEY JORDAN WILTON DNP, CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 1501 N CAMPBELL AVE
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City | TUCSON
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State | AZ
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Zip | 85724-0001
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Country | US
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Telephone | 520-694-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 7060 E OPATAS PL
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City | TUCSON
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State | AZ
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Zip | 85715-3340
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AC002852
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA1418
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License Number State | AZ
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