Provider Demographics
NPI:1891359352
Name:HALLENBECK, ASHLIE (LVN)
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:
Last Name:HALLENBECK
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 KACHINA LN
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-3332
Mailing Address - Country:US
Mailing Address - Phone:214-399-3254
Mailing Address - Fax:
Practice Address - Street 1:1121 KACHINA LN
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3332
Practice Address - Country:US
Practice Address - Phone:214-399-3254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333199164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse