Provider Demographics
NPI:1598477713
Name:BEDFORD, ASHLEY LANORA (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LANORA
Last Name:BEDFORD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 COUNTRY PLACE PKWY STE 109
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5121
Mailing Address - Country:US
Mailing Address - Phone:832-672-8026
Mailing Address - Fax:
Practice Address - Street 1:1801 COUNTRY PLACE PKWY STE 109
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5121
Practice Address - Country:US
Practice Address - Phone:832-672-8026
Practice Address - Fax:832-230-4172
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily