Basic Information
| Provider Information | |||||||||
| NPI: | 1629309968 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HORSTMAN | ||||||||
| FirstName: | ASHLEA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 843966 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641843966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738823300 | ||||||||
| FaxNumber: | 5738840943 | ||||||||
| Practice Location | |||||||||
| Address1: | 2613 FAIRWAY DR | ||||||||
| Address2: | SUITE C | ||||||||
| City: | FULTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652514030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736421990 | ||||||||
| FaxNumber: | 5736425089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2010 | ||||||||
| LastUpdateDate: | 08/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2010005186 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.