Provider Demographics
NPI:1114535937
Name:ROSSO, ASHLEY ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:ROSSO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1162 MONTGOMERY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4802
Mailing Address - Country:US
Mailing Address - Phone:707-890-4100
Mailing Address - Fax:707-476-2237
Practice Address - Street 1:1162 MONTGOMERY DR STE 2
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4802
Practice Address - Country:US
Practice Address - Phone:707-890-4100
Practice Address - Fax:707-476-2237
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95014942363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology