MEDICARE: ASHLEY PRITCHARD FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	C-APN.0002690-C-NP	CO
2	363LF0000X	Family Nurse Practitioner	810469	NV

General Provider Information

NPI Number	:	1043815335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY PRITCHARD FNP-BC

Provider Business Mailing Address
First Line	:	1465 KELLY JOHNSON BLVD
Second Line	:	STE 110
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3945
Country	:	US
Telephone Number	:	404-447-9945
Fax Number	:

Provider Business Practice Location Address
First Line	:	7035 W ANN RD STE 160
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3868
Country	:	US
Telephone Number	:	702-369-0722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	06/08/2021

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