Basic Information
Provider Information
NPI: 1235382391
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STOWERS
FirstName: ASHLEY
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SHORT
OtherFirstName: ASHLEY
OtherMiddleName: ELIZABETH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA-C
OtherLastNameType: 1
Mailing Information
Address1: 9913 N 95TH ST
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852584586
CountryCode: US
TelephoneNumber: 4808608998
FaxNumber: 4803779245
Practice Location
Address1: 9913 N 95TH ST
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852584586
CountryCode: US
TelephoneNumber: 4808608998
FaxNumber: 4803779245
Other Information
ProviderEnumerationDate: 11/02/2008
LastUpdateDate: 07/24/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X4323AZY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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