Provider Demographics
NPI:1629309968
Name:HORSTMAN, ASHLEA ELIZABETH (PA)
Entity Type:Individual
Prefix:
First Name:ASHLEA
Middle Name:ELIZABETH
Last Name:HORSTMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-882-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:2613 FAIRWAY DR
Practice Address - Street 2:SUITE C
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-4030
Practice Address - Country:US
Practice Address - Phone:573-642-1990
Practice Address - Fax:573-642-5089
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010005186363A00000X
MO2010002245363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant