Healthcare Provider Details

I. General information

NPI: 1437913290
Provider Name (Legal Business Name): ASHLEY BROOKE JUNGJOHAN CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 CAPITAL AVE SW STE 102
BATTLE CREEK MI
49015-4194
US

IV. Provider business mailing address

4091 SARATOGA AVE
KALAMAZOO MI
49048-1075
US

V. Phone/Fax

Practice location:
  • Phone: 616-528-4644
  • Fax: 269-360-4824
Mailing address:
  • Phone: 616-528-4644
  • Fax: 269-360-4824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number7601000133
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: