Basic Information
Provider Information
NPI: 1134799034
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBISON
FirstName: ASHLEY
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 802843
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641802843
CountryCode: US
TelephoneNumber: 4177306430
FaxNumber: 4172697567
Practice Location
Address1: 3801 S NATIONAL AVE STE 1122
Address2:  
City: SPRINGFIELD
State: MO
PostalCode: 658076090
CountryCode: US
TelephoneNumber: 4172697728
FaxNumber: 4172697729
Other Information
ProviderEnumerationDate: 07/01/2021
LastUpdateDate: 05/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X2020020883MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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