MEDICARE: ASHLEY POWELL APRN

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	363LF0000X	Family Nurse Practitioner	209034719	IL

General Provider Information

NPI Number	:	1467305987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY POWELL APRN

Provider Business Mailing Address
First Line	:	101 W UNIVERSITY AVE
Second Line	:
City	:	CHAMPAIGN
State	:	IL
Zip	:	61820-3909
Country	:	US
Telephone Number	:	217-366-5434
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 W WINDSOR RD
Second Line	:
City	:	CHAMPAIGN
State	:	IL
Zip	:	61822-6217
Country	:	US
Telephone Number	:	217-366-5434
Fax Number	:	217-366-8074

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	04/15/2026

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Directions to “ ASHLEY POWELL APRN” Practice Location

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