| Ashley N Weathers, CFNP | |
| 
					109 N Broadway St, South West City, MO 64863-9417  | |
| (417) 762-3287 | |
| (417) 762-3255 | 
| Full Name | Ashley N Weathers | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Primary Care | 
| Location | 109 N Broadway St, South West City, Missouri | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1629734934 | NPI | - | NPPES | 
| 436809082 | Other | MO | FEIN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LP2300X | Nurse Practitioner - Primary Care | 2021038566 (Missouri) | Primary | 
| Entity Name | Mercy Clinic Springfield Communities | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1245277631 PECOS PAC ID: 7416865845 Enrollment ID: O20031104000060  | 
| Entity Name | Mercy Clinic Springfield Communities | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1972771657 PECOS PAC ID: 7416865845 Enrollment ID: O20031218000354  | 
| Entity Name | Sgoh Acquisition Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1114924768 PECOS PAC ID: 5092616276 Enrollment ID: O20040205000647  | 
| Entity Name | Mercy Clinic Joplin Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1215264817 PECOS PAC ID: 0547300196 Enrollment ID: O20091218000092  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ashley N Weathers, CFNP 109 N Broadway St, South West City, MO 64863-9417 Ph: (417) 762-3287  | Ashley N Weathers, CFNP 109 N Broadway St, South West City, MO 64863-9417 Ph: (417) 762-3287  | 
Shaye Wilson, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10700 S State Highway 43, South West City, MO 64863 Phone: 417-762-5250 Fax: 177-625-2524  | |
Audrey Anne Hubler, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 109 N Broadway St, South West City, MO 64863 Phone: 417-762-3287 Fax: 417-762-3255  |