MEDICARE: ASHLEY LYNN MATHEW NP

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	363L00000X	Nurse Practitioner	4704270221	MI
2	363LA2100X	Acute Care Nurse Practitioner	4704270221	MI

General Provider Information

NPI Number	:	1942756325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LYNN MATHEW NP

Provider Business Mailing Address
First Line	:	4000 WELLNESS DR
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48670-2000
Country	:	US
Telephone Number	:	989-839-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2463 S M 30
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-9312
Country	:	US
Telephone Number	:	989-839-1644
Fax Number	:	989-839-3029

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

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	03/09/2026

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