Healthcare Provider Details

I. General information

NPI: 1770357758
Provider Name (Legal Business Name): ASHLEY STROBRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19298 RAYMOND ST
GROSSE POINTE WOODS MI
48236-1928
US

IV. Provider business mailing address

19298 RAYMOND ST
GROSSE POINTE WOODS MI
48236-1928
US

V. Phone/Fax

Practice location:
  • Phone: 248-318-2089
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704359572
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: