Provider Demographics
NPI:1669743852
Name:MATTNER, ASHLEY N (CRNA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:N
Last Name:MATTNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:N
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1613 HARRISON PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2896
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:3RD FLOOR ANESTHESIA DEPT
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:817-927-1417
Practice Address - Fax:817-927-3740
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX702801367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered