Healthcare Provider Details

I. General information

NPI: 1184230054
Provider Name (Legal Business Name): ASHLEY STOECKLE NACNS WOCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 OAKWOOD BLVD
DEARBORN MI
48124-4089
US

IV. Provider business mailing address

36416 DOVER ST
LIVONIA MI
48150-3583
US

V. Phone/Fax

Practice location:
  • Phone: 313-593-5838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number4704292798
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: