Provider Demographics
NPI:1518417393
Name:ABEITA, ASHLEY ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:ABEITA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22A TRIBAL ROAD 22
Mailing Address - Street 2:
Mailing Address - City:BOSQUE FARMS
Mailing Address - State:NM
Mailing Address - Zip Code:87068-8123
Mailing Address - Country:US
Mailing Address - Phone:505-615-3062
Mailing Address - Fax:
Practice Address - Street 1:22 TR 22 # A
Practice Address - Street 2:
Practice Address - City:BOSQUE FARMS
Practice Address - State:NM
Practice Address - Zip Code:87068-8123
Practice Address - Country:US
Practice Address - Phone:505-615-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other