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NPI Code Detail

MEDICARE: ASHLEY SHASTA DAVIS FNP

MEDICARE: ASHLEY SHASTA DAVIS FNP
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
1363LF0000XFamily Nurse Practitioner239842LA
2363L00000XNurse Practitioner239842LA

General Provider Information

NPI Number : 1336945310
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY SHASTA DAVIS FNP
Provider Business Mailing Address
First Line : 26030 STONEHENGE DR
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-6077
Country : US
Telephone Number : 225-955-4623
Fax Number :
Provider Business Practice Location Address
First Line : 2390 W CONGRESS ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-4205
Country : US
Telephone Number : 337-261-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2025
Last Update Date : 12/24/2025

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