Provider Demographics
NPI:1629550876
Name:AGUIRRE, ASHLEA
Entity Type:Individual
Prefix:MRS
First Name:ASHLEA
Middle Name:
Last Name:AGUIRRE
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 1:1445 HAYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-3445
Mailing Address - Country:US
Mailing Address - Phone:806-239-9391
Mailing Address - Fax:
Practice Address - Street 1:1445 HAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-3445
Practice Address - Country:US
Practice Address - Phone:806-239-9391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX317694164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse