Provider Demographics
NPI:1851901409
Name:DAVIDSON, ASHLEY NICOLE (NP)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:TX
Mailing Address - Zip Code:79346-3444
Mailing Address - Country:US
Mailing Address - Phone:806-300-8996
Mailing Address - Fax:806-266-5564
Practice Address - Street 1:201 E GRANT AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:TX
Practice Address - Zip Code:79346-3444
Practice Address - Country:US
Practice Address - Phone:806-300-8996
Practice Address - Fax:806-266-5564
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1007766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily