Provider Demographics
NPI:1770134561
Name:TUNSTALL, ASHLEY BROOKE (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROOKE
Last Name:TUNSTALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 MEDICAL DR STE 401
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5206
Mailing Address - Country:US
Mailing Address - Phone:903-553-7680
Mailing Address - Fax:903-553-7688
Practice Address - Street 1:802 MEDICAL DR STE 401
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5206
Practice Address - Country:US
Practice Address - Phone:903-553-7680
Practice Address - Fax:903-553-7688
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140933363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner