Individual
ASHLEY LAUREN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
940 RIVER CENTRE DR, PORT HURON, MI 48060-4463
(810) 985-4900
(810) 985-3634
Mailing address
940 RIVER CENTRE DR, PORT HURON, MI 48060-4463
(810) 985-4900
(810) 985-3634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
56010078889
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093265225
—
MI
Enumeration date
10/12/2016
Last updated
06/27/2025
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