Provider Demographics
NPI:1467499319
Name:TROMBLEY, ASHLEY BROOKS (CNS)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:BROOKS
Last Name:TROMBLEY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 S UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6520
Mailing Address - Country:US
Mailing Address - Phone:918-403-6348
Mailing Address - Fax:918-403-6348
Practice Address - Street 1:1923 S UTICA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-6520
Practice Address - Country:US
Practice Address - Phone:918-748-7650
Practice Address - Fax:918-403-6348
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0073063364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200039170AMedicaid
OK249717407Medicare PIN
OKQ17165Medicare UPIN
OK242419400Medicare ID - Type Unspecified