Provider Demographics
NPI:1396413175
Name:ANDERSON, ASHLEY ERIKA (RN)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:ERIKA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4428 E LESTER ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3418
Mailing Address - Country:US
Mailing Address - Phone:815-985-9831
Mailing Address - Fax:
Practice Address - Street 1:4428 E LESTER ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3418
Practice Address - Country:US
Practice Address - Phone:815-985-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-05
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN196711163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health