Healthcare Provider Details

I. General information

NPI: 1144092131
Provider Name (Legal Business Name): ASHTEN WHITNI EMBRY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 TOWN SQUARE DR
BEAVER DAM KY
42320-9135
US

IV. Provider business mailing address

1101 TOWN SQUARE DR
BEAVER DAM KY
42320-9135
US

V. Phone/Fax

Practice location:
  • Phone: 270-775-6060
  • Fax: 270-775-6010
Mailing address:
  • Phone: 270-775-6060
  • Fax: 270-775-6010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4010727
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: