Provider Demographics
NPI:1578557005
Name:FOLSOM, AILEY ANN (RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AILEY
Middle Name:ANN
Last Name:FOLSOM
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:MS
Other - First Name:AILEY
Other - Middle Name:ANN
Other - Last Name:RUNYON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP-C
Mailing Address - Street 1:3517 SW WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-6159
Mailing Address - Country:US
Mailing Address - Phone:817-447-1151
Mailing Address - Fax:817-529-8927
Practice Address - Street 1:3517 SW WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:JOSHUA
Practice Address - State:TX
Practice Address - Zip Code:76058-6159
Practice Address - Country:US
Practice Address - Phone:817-447-1151
Practice Address - Fax:817-529-8927
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ40423Medicare UPIN