MEDICARE: JOHN WILLIAM ASHLEY 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	APRN11006618	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528694882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WILLIAM ASHLEY APRN

Provider Business Mailing Address
First Line	:	1204 CARLTON AVE
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-4318
Country	:	US
Telephone Number	:	863-456-4091
Fax Number	:	863-456-4089

Provider Business Practice Location Address
First Line	:	1204 CARLTON AVE
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33853-4318
Country	:	US
Telephone Number	:	863-456-4091
Fax Number	:	863-456-4089

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

Provider Enumeration Date	:	03/19/2020
Last Update Date	:	01/05/2026

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