MEDICARE: MRS. DIONNE MEBANE-ASHTON CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	R139607	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104819267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIONNE MEBANE-ASHTON CRNP

Provider Business Mailing Address
First Line	:	2614 RAINY SPRING CT
Second Line	:
City	:	ODENTON
State	:	MD
Zip	:	21113-3304
Country	:	US
Telephone Number	:	410-305-1226
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 LIBERTY HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-8019
Country	:	US
Telephone Number	:	410-383-8300
Fax Number	:	410-383-3160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	03/08/2021

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