Provider Demographics
NPI:1467861898
Name:BOOTHE, ASHLEY (FNP-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BOOTHE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 INWOOD RD
Mailing Address - Street 2:OUTPATIENT BUILDING 7TH FLOOR
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8873
Mailing Address - Country:US
Mailing Address - Phone:214-645-0538
Mailing Address - Fax:214-645-0536
Practice Address - Street 1:1801 INWOOD RD
Practice Address - Street 2:OUTPATIENT BUILDING 7TH FLOOR
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8873
Practice Address - Country:US
Practice Address - Phone:214-645-0538
Practice Address - Fax:214-645-0536
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily