Provider Demographics
NPI:1912371964
Name:DEGRUSH, ASHLEY DIANNE (FNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DIANNE
Last Name:DEGRUSH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7173 S HAVANA ST STE 100-81
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3891
Mailing Address - Country:US
Mailing Address - Phone:303-718-6899
Mailing Address - Fax:303-374-2518
Practice Address - Street 1:7173 S HAVANA ST STE 100-81
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3891
Practice Address - Country:US
Practice Address - Phone:303-718-6899
Practice Address - Fax:303-374-2518
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily