Basic Information
| Provider Information | |||||||||
| NPI: | 1568899565 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COENRAAD | ||||||||
| FirstName: | ASHLYN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN, MSN, CPNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4351 DFW TPKE | ||||||||
| Address2: | #202 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752111501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694884300 | ||||||||
| FaxNumber: | 4694884301 | ||||||||
| Practice Location | |||||||||
| Address1: | 4351 DFW TPKE | ||||||||
| Address2: | #202 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752111501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694884300 | ||||||||
| FaxNumber: | 4694884301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2013 | ||||||||
| LastUpdateDate: | 10/04/2013 | ||||||||
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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 | 363LP0200X | 757854 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.