Healthcare Provider Details

I. General information

NPI: 1144148149
Provider Name (Legal Business Name): ASHLEY NOBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 E WARREN AVE
DETROIT MI
48215-2061
US

IV. Provider business mailing address

16613 CARLISLE ST
DETROIT MI
48205-1503
US

V. Phone/Fax

Practice location:
  • Phone: 800-615-0411
  • Fax:
Mailing address:
  • Phone: 313-955-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number202K00000X
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: