Provider Demographics
NPI:1396478574
Name:MALONE, ASHLEY LAUREN
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LAUREN
Last Name:MALONE
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 1:13688 S HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-2842
Mailing Address - Country:US
Mailing Address - Phone:918-417-0667
Mailing Address - Fax:
Practice Address - Street 1:300 N DENVER AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-1420
Practice Address - Country:US
Practice Address - Phone:918-596-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist