Provider Demographics
NPI:1851911341
Name:ROYBAL, ASHLEE BROOKE
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:BROOKE
Last Name:ROYBAL
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:WUSM PEDS, 1 CHILDRENS PL, MSC 8208-0016-01
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-2527
Mailing Address - Fax:314-747-8880
Practice Address - Street 1:WUSM PEDS, 1 CHILDRENS PL, MSC 8208-0016-01
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2527
Practice Address - Fax:314-747-8880
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023026708208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics