Provider Demographics
NPI:1487353876
Name:ATTAWAY, ASHLEY (AGPCNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ATTAWAY
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E DEBBIE LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3674
Mailing Address - Country:US
Mailing Address - Phone:817-473-9125
Mailing Address - Fax:817-473-9126
Practice Address - Street 1:1601 E DEBBIE LN
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3674
Practice Address - Country:US
Practice Address - Phone:817-473-9125
Practice Address - Fax:817-473-9126
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056945363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health