MEDICARE: ASHLEY-KATE ROBERSON APRN

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	363LF0000X	Family Nurse Practitioner	215378	LA

General Provider Information

NPI Number	:	1134012792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY-KATE ROBERSON APRN

Provider Business Mailing Address
First Line	:	1455 E BERT KOUNS INDUSTRIAL LOOP
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-6000
Country	:	US
Telephone Number	:	318-798-4539
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 E BERT KOUN LOOP STE 101
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-6000
Country	:	US
Telephone Number	:	318-798-4424
Fax Number	:	866-502-4997

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	03/12/2026

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