Healthcare Provider Details

I. General information

NPI: 1376494575
Provider Name (Legal Business Name): ASHLEY N BENNETT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N COLLEGE ST
LINCOLN IL
62656-1401
US

IV. Provider business mailing address

515 N COLLEGE ST
LINCOLN IL
62656-1401
US

V. Phone/Fax

Practice location:
  • Phone: 217-732-9681
  • Fax:
Mailing address:
  • Phone: 217-732-9681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209035990
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041547739
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: