Individual
MRS. ASHLEY REAGAN SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5000
Mailing address
4882 DIEHL ARD, METAMORA, MI 48455
(248) 941-6964
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704281404
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704281404
MI
Other
Enumeration date
12/12/2016
Last updated
11/30/2020
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