Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | APN0995613 | CO |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APN.0995613-NP | CO |
NPI | 1073121943 |
---|---|
Provider Name | Ashley Benally-Ross |
First Address | Colorado Springs, CO 80904-4023 |
Second Address | Colorado Springs, CO 80904-4023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2020 |
Last Update Date | 16/07/2020 |