Provider Demographics
NPI:1427235423
Name:KIRBY, ASHLEY NICHOLE (NP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICHOLE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:NICHOLE
Other - Last Name:OLVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:131 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3415
Mailing Address - Country:US
Mailing Address - Phone:719-924-9398
Mailing Address - Fax:719-924-9593
Practice Address - Street 1:131 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3415
Practice Address - Country:US
Practice Address - Phone:719-924-9398
Practice Address - Fax:719-924-9593
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO169877163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06D2025909OtherCLIA