Healthcare Provider Details

I. General information

NPI: 1700450947
Provider Name (Legal Business Name): ASHLEY M STROOT APRN-CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 BROADWAY ST
QUINCY IL
62301-3713
US

IV. Provider business mailing address

3301 BROADWAY ST
QUINCY IL
62301-3713
US

V. Phone/Fax

Practice location:
  • Phone: 217-277-4040
  • Fax: 217-275-5282
Mailing address:
  • Phone: 217-277-4090
  • Fax: 217-277-6778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209.023565
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.397933
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: