Individual
ASHLEY VANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A-GACNP
Contact information
Practice address
7901 ANGLING RD, PORTAGE, MI 49024-0714
(269) 324-8426
Mailing address
10820 CHICORY TRL, MATTAWAN, MI 49071-8567
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704303936
MI
363LA2100X
Acute Care Nurse Practitioner
4704303936
MI
Other
Enumeration date
03/30/2023
Last updated
07/31/2023
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