Provider Demographics
NPI:1093338568
Name:GRESHAM, ASHLEE NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEE
Middle Name:NICOLE
Last Name:GRESHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:NICOLE
Other - Last Name:BIRKENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 MIDWESTERN PKWY E
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76302-2302
Mailing Address - Country:US
Mailing Address - Phone:940-716-5788
Mailing Address - Fax:940-761-8575
Practice Address - Street 1:501 MIDWESTERN PKWY E
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2302
Practice Address - Country:US
Practice Address - Phone:940-716-5788
Practice Address - Fax:940-766-8497
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU0124207Q00000X
OK35943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine