1558217646 NPI number — ASHLEY DAWN ROBERTS APRN, FNP-C

Table of content: ASHLEY DAWN ROBERTS APRN, FNP-C (NPI 1558217646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558217646 NPI number — ASHLEY DAWN ROBERTS APRN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBERTS
Provider First Name:
ASHLEY
Provider Middle Name:
DAWN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558217646
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
631 S 110TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDWARDSVILLE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66111-1051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-636-2140
Provider Business Mailing Address Fax Number:
913-204-0378

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
631 S 110TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDWARDSVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66111-1051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-636-2140
Provider Business Practice Location Address Fax Number:
913-204-0378
Provider Enumeration Date:
03/10/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  53-85196-031 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com