Healthcare Provider Details

I. General information

NPI: 1730961541
Provider Name (Legal Business Name): ASHLEY LEWIS DNP FNP-BC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MICHIGAN ST NE
GRAND RAPIDS MI
49503-3314
US

IV. Provider business mailing address

1801 W LAKEWOOD RD
WHITEHALL MI
49461-9223
US

V. Phone/Fax

Practice location:
  • Phone: 616-331-3558
  • Fax:
Mailing address:
  • Phone: 231-329-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704341118
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: