Provider Demographics
NPI:1639157472
Name:ASHBY, CYNTHIA J (NNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:ASHBY
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3972
Mailing Address - Country:US
Mailing Address - Phone:303-544-5777
Mailing Address - Fax:303-544-5775
Practice Address - Street 1:4747 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1133
Practice Address - Country:US
Practice Address - Phone:720-854-7152
Practice Address - Fax:720-754-7114
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3076363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20407378Medicaid
CO537488Medicare ID - Type Unspecified
CO20407378Medicaid
COC537488Medicare PIN