Individual provider · NPI-1

Ashlie Vandine-Rose Abraham, NP

Nurse Practitioner, Pediatrics · San Antonio, TX

NPI number1669931275
StatusActive
Last updated in NPPESApr 9, 2020

Details

NPI
1669931275
Entity type
Individual (NPI-1)
Name
Ashlie Vandine-Rose Abraham
Credential
NP
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 14, 2019
Certification date
Apr 9, 2020
Last updated
Apr 9, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsAP142549TXYes

Practice location

333 N Santa Rosa St
San Antonio, TX 78207-3108

Phone 210-704-2011

Mailing address

7206 Still Brook St
San Antonio, TX 78238-2736

Other practice locations

7206 Still Brook St
San Antonio, TX 78238-2736

Phone 210-840-6102

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