Healthcare Provider Details

I. General information

NPI: 1114461274
Provider Name (Legal Business Name): ASHTON MAE WESTER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N DACIE PT
LECANTO FL
34461-8399
US

IV. Provider business mailing address

525 N DACIE PT
LECANTO FL
34461-8399
US

V. Phone/Fax

Practice location:
  • Phone: 352-746-2200
  • Fax: 352-746-9320
Mailing address:
  • Phone: 352-746-2200
  • Fax: 352-746-9320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9311548
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: