Provider Demographics
NPI:1831406594
Name:HENES, ASHLEY ROSEANNA (PA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ROSEANNA
Last Name:HENES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ROSEANNA
Other - Last Name:FROEDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3773 E CHERRY CREEK NORTH DR
Mailing Address - Street 2:SUITE 970 WEST TOWER
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3804
Mailing Address - Country:US
Mailing Address - Phone:303-388-5629
Mailing Address - Fax:303-321-7586
Practice Address - Street 1:3773 E CHERRY CREEK NORTH DR
Practice Address - Street 2:SUITE 970 WEST TOWER
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3804
Practice Address - Country:US
Practice Address - Phone:303-388-5629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005824363A00000X
CO0003691363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4349267Medicaid
1104063155Medicare NSC
MIMI2669001Medicare PIN
D91326Medicare UPIN
1104063155Medicare Oscar/Certification