Provider Demographics
NPI:1003200965
Name:NOBOA, ASHLEY RAE (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:RAE
Last Name:NOBOA
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:RAE
Other - Last Name:MARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3355 BAINBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2801
Mailing Address - Country:US
Mailing Address - Phone:347-703-8799
Mailing Address - Fax:718-547-2929
Practice Address - Street 1:3415 BAINBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2403
Practice Address - Country:US
Practice Address - Phone:718-920-7200
Practice Address - Fax:718-547-2929
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127819363LF0000X
NY340189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily