Healthcare Provider Details

I. General information

NPI: 1548497084
Provider Name (Legal Business Name): ASHLEY CLARK APRN, NP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY DANIELLE YOUNG APRN, NP-C, PMHNP-BC

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 WESTFORK DR STE 401
BATON ROUGE LA
70827-0004
US

IV. Provider business mailing address

PO BOX 1726
WALKER LA
70785-1726
US

V. Phone/Fax

Practice location:
  • Phone: 225-255-0899
  • Fax: 225-341-4345
Mailing address:
  • Phone: 225-255-0899
  • Fax: 225-341-4345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP06868
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0100900-C-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC005595
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP06868
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP06868
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number122036
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: