Provider Demographics
NPI:1518512904
Name:MISCHKE, ASHLEY NICOLE (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:MISCHKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:ENYART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6124 W PARKER RD STE 234
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8124
Mailing Address - Country:US
Mailing Address - Phone:972-468-9999
Mailing Address - Fax:972-981-3600
Practice Address - Street 1:6124 W PARKER RD STE 234
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8124
Practice Address - Country:US
Practice Address - Phone:972-468-9999
Practice Address - Fax:972-981-3600
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant