Provider Demographics
NPI:1285728923
Name:ASHBAUGH, YVONNE MARIE (NP)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:MARIE
Last Name:ASHBAUGH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-6770
Mailing Address - Fax:
Practice Address - Street 1:5901 HARPER DRIVE NE
Practice Address - Street 2:PHS WOUND CENTER
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3589
Practice Address - Country:US
Practice Address - Phone:505-823-8870
Practice Address - Fax:505-823-8875
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02737363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1880445-03Medicaid
TX8Y5581OtherBCBS TX PIN
TX1880445-03Medicaid