Basic Information
Provider Information
NPI: 1033714589
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORTON
FirstName: ASHLEY
MiddleName: NICOLE
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8000 E MAPLEWOOD AVE STE 200
Address2:  
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801114727
CountryCode: US
TelephoneNumber: 8883398727
FaxNumber:  
Practice Location
Address1: 11600 W 2ND PL
Address2:  
City: LAKEWOOD
State: CO
PostalCode: 802281527
CountryCode: US
TelephoneNumber: 7203210000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/02/2020
LastUpdateDate: 03/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X1626969CON Nursing Service ProvidersRegistered Nurse 
367500000X0996229COY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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