Basic Information
| Provider Information | |||||||||
| NPI: | 1538526454 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TROWBRIDGE | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MENTA | ||||||||
| OtherFirstName: | ASHLEY | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5012 S US HIGHWAY 75 STE 300 | ||||||||
| Address2: | ATTN BILLING | ||||||||
| City: | DENISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750204589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9034166200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5012 S US HIGHWAY 75 STE 110 | ||||||||
| Address2: | |||||||||
| City: | DENISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750204596 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9034166200 | ||||||||
| FaxNumber: | 9034166201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2016 | ||||||||
| LastUpdateDate: | 04/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 771271 | TX | N | Nursing Service Providers | Registered Nurse | 363LF0000X | AP130077 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 354731701 | 05 | TX | MEDICAID | 200625060A | 05 | OK | MEDICAID |