Healthcare Provider Details

I. General information

NPI: 1326929977
Provider Name (Legal Business Name): ASHLEY FLINT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 RIVER WOODS RD
LAKE CITY MI
49651-9178
US

IV. Provider business mailing address

4910 RIVER WOODS RD
LAKE CITY MI
49651-9178
US

V. Phone/Fax

Practice location:
  • Phone: 989-304-0196
  • Fax:
Mailing address:
  • Phone: 989-304-0196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704306454
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: