MEDICARE: ASHLEY STATEN NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	109737	WV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G164793	IA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	TPAN457	FL
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	24853	SC
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3016139	KY
6	363LF0000X	Family Nurse Practitioner	RN219937	GA
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	316756	AZ
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0033758	OH
9	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN219937	GA

General Provider Information

NPI Number	:	1699322370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY STATEN NP

Provider Business Mailing Address
First Line	:	340 S LEMON AVE # 9892
Second Line	:
City	:	WALNUT
State	:	CA
Zip	:	91789-2706
Country	:	US
Telephone Number	:	415-651-3458
Fax Number	:

Provider Business Practice Location Address
First Line	:	2739 HUNTCLIFFE DR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-0662
Country	:	US
Telephone Number	:	405-403-2156
Fax Number	:

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

Provider Enumeration Date	:	08/19/2019
Last Update Date	:	02/11/2026

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Directions to “ ASHLEY STATEN NP” Practice Location

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