MEDICARE: MRS. ASHLEY RANDLEMAN CHAZANOW CPNP

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	5020837	NC

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	:	1235587890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY RANDLEMAN CHAZANOW CPNP

Provider Business Mailing Address
First Line	:	PO BOX 803854
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64180-3854
Country	:	US
Telephone Number	:	919-350-0351
Fax Number	:	919-350-7687

Provider Business Practice Location Address
First Line	:	101 HOLLY CREEK RD
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-9509
Country	:	US
Telephone Number	:	919-235-6512
Fax Number	:

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

Provider Enumeration Date	:	05/24/2016
Last Update Date	:	10/29/2025

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