Provider Demographics
NPI:1649904368
Name:LEAL, ASHLEY CAITLAN (MSN, RN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CAITLAN
Last Name:LEAL
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Gender:F
Credentials:MSN, RN, CPNP-PC
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Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:3200 RIVERFRONT DR STE 103
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6560
Practice Address - Country:US
Practice Address - Phone:817-336-3800
Practice Address - Fax:817-335-9454
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2024-04-22
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Provider Licenses
StateLicense IDTaxonomies
TX1087098363LP0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1087098OtherAPRN
TX44365OtherPRESCRIPTIVE AUTHORITY