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Individual

ASHLEY STACY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5500 BELLE RIVER BLVD, EAST CHINA, MI 48054-4108
(810) 335-2585
Mailing address
5500 BELLE RIVER BLVD, EAST CHINA, MI 48054-4108

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116323
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
382500514
MI
Enumeration date
03/14/2016
Last updated
03/14/2016
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