Provider Demographics
NPI:1891160925
Name:LAIR, ASHLEY (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LAIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 PARFET ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5574
Mailing Address - Country:US
Mailing Address - Phone:720-480-7546
Mailing Address - Fax:303-239-7157
Practice Address - Street 1:645 PARFET ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215
Practice Address - Country:US
Practice Address - Phone:720-480-7546
Practice Address - Fax:303-239-7157
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0196312163W00000X
CO0196312163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1891160925Medicaid