Provider Demographics
NPI:1659650125
Name:AHRBERG, ASHLEIGH (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:AHRBERG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 BROADWAY EXT STE 200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6323
Mailing Address - Country:US
Mailing Address - Phone:405-608-8833
Mailing Address - Fax:405-608-8818
Practice Address - Street 1:9900 BROADWAY EXT STE 200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6323
Practice Address - Country:US
Practice Address - Phone:405-608-8833
Practice Address - Fax:405-608-8818
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2032363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical