MEDICARE: ASHLEE ANN MATTHEWS APRN, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	871042	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1042598	TX

General Provider Information

NPI Number	:	1043842891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEE ANN MATTHEWS APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	9901 BRODIE LN STE 160
Second Line	:	BOX 1189
City	:	AUSTIN
State	:	TX
Zip	:	78748-5892
Country	:	US
Telephone Number	:	737-443-0119
Fax Number	:	512-514-0916

Provider Business Practice Location Address
First Line	:	7701 RIALTO BLVD APT 128
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-7402
Country	:	US
Telephone Number	:	512-698-2556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2020
Last Update Date	:	07/21/2021

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