Provider Demographics
NPI:1962287771
Name:FROMM, ASHLEY TARYN (RN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:TARYN
Last Name:FROMM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:TARYN
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6800 E MAYO BLVD APT 4302
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-5632
Mailing Address - Country:US
Mailing Address - Phone:480-678-2142
Mailing Address - Fax:
Practice Address - Street 1:6800 E MAYO BLVD APT 4302
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-5632
Practice Address - Country:US
Practice Address - Phone:480-678-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ267069163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory