Provider Demographics
NPI:1083225122
Name:FELICIANO-ROSARIO, ASHLEY (APRN, AGACNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:FELICIANO-ROSARIO
Suffix:
Gender:F
Credentials:APRN, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 GREENVILLE AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-7906
Mailing Address - Country:US
Mailing Address - Phone:214-369-3613
Mailing Address - Fax:
Practice Address - Street 1:7150 GREENVILLE AVE STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7906
Practice Address - Country:US
Practice Address - Phone:214-369-3613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX879990163WC0200X
TX1005540363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine