Provider Demographics
NPI:1770297798
Name:EDWARDS, ASHLEE RAE (MSN, RN)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:RAE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:RAE
Other - Last Name:MALDONADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 N ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4723
Mailing Address - Country:US
Mailing Address - Phone:775-786-3040
Mailing Address - Fax:775-786-1887
Practice Address - Street 1:555 N ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4723
Practice Address - Country:US
Practice Address - Phone:775-786-3040
Practice Address - Fax:775-788-5209
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV863735363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
15773882OtherCAQH