Individual
ASHLEIGH D ROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7150
Mailing address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-7150
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
62175914405
UT
363LG0600X
Gerontology Nurse Practitioner
6217591
UT
363LG0600X
Gerontology Nurse Practitioner
62175914405
UT
Other
Enumeration date
08/27/2019
Last updated
04/10/2020
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