Basic Information
| Provider Information | |||||||||
| NPI: | 1033663265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | ASHLEY | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 640 W MOANA LN | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895094903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753240699 | ||||||||
| FaxNumber: | 7753236814 | ||||||||
| Practice Location | |||||||||
| Address1: | 975 RYLAND ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759825000 | ||||||||
| FaxNumber: | 7759825225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2016 | ||||||||
| LastUpdateDate: | 06/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA1770 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | PA1770 | 01 | NV | PA-C LICENSURE | OTHER |