Provider Demographics
NPI:1962858159
Name:AUSTIN, ASHLEY SHARI (ANP)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:SHARI
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63006-0012
Mailing Address - Country:US
Mailing Address - Phone:314-928-0928
Mailing Address - Fax:888-440-2472
Practice Address - Street 1:10004 KENNERLY RD STE 370A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-5118
Practice Address - Country:US
Practice Address - Phone:314-928-0928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014034199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner