1295264000 NPI number — MRS. ASHLEY CHRISTINE PENDLETON ND

Table of content: MRS. ASHLEY CHRISTINE PENDLETON ND (NPI 1295264000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295264000 NPI number — MRS. ASHLEY CHRISTINE PENDLETON ND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PENDLETON
Provider First Name:
ASHLEY
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ND
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
PENDLETON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ND
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295264000
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1130 E MISSOURI AVE
Provider Second Line Business Mailing Address:
STE 850
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-536-9887
Provider Business Mailing Address Fax Number:
602-563-8218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1130 E MISSOURI AVE
Provider Second Line Business Practice Location Address:
STE 850
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-536-9887
Provider Business Practice Location Address Fax Number:
602-563-8218
Provider Enumeration Date:
06/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 175F00000X , with the licence number:  17-1615 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com