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General NPI Number Information
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NPI Number | 1770177131
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Entity Type | Organization
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Legal Business Name | ASH FAMILY MEDICAL LLC
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 2256 36TH AVENUE SUITE 200
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City | NORMAN
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State | OK
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Zip | 73072
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Country | US
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Telephone | 405-701-9994
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Fax | 405-701-9996
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Provider Business Mailing Address
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Address Line | PO BOX 720505
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City | NORMAN
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State | OK
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Zip | 73070
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Country | US
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Telephone | 405-701-9994
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Fax | 405-701-9996
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Authorized Official
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Title or Position | OWNER
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Name | SHANDA LYNN GOWER
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Credential | APRN
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Telephone | 405-206-6883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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