Individual
NANCY ASHWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
310 W SYCAMORE AVE, BLOOMFIELD, NM 87413-5844
(505) 634-3673
(505) 634-3675
Mailing address
2619 N MOSSMAN DR, FARMINGTON, NM 87401-9401
(505) 634-3673
(505) 634-3675
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L05799
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64434826
—
NM
Enumeration date
05/18/2007
Last updated
07/09/2007
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