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Michael J Ashlock, RN

Registered Nurse, General Practice in Gallup, NM. Individual provider (NPI-1).

NPI number1386252583
StatusActive
Last updated in NPPESJul 14, 2020

Details

NPI
1386252583
Entity type
Individual (NPI-1)
Name
Michael J Ashlock
Credential
RN
Sex
Male
Sole proprietor
No
Enumeration date
Jul 14, 2020
Certification date
Jul 14, 2020
Last updated
Jul 14, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General PracticeCA95089825CAYes

Practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Phone 505-722-1000

Mailing address

18425 Burbank Blvd Ste 508
Tarzana, CA 91356-6692

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