Healthcare Provider Details

I. General information

NPI: 1205723392
Provider Name (Legal Business Name): ASHLEY HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18316 MIDDLEBELT RD
LIVONIA MI
48152-5007
US

IV. Provider business mailing address

30000 HIVELEY ST
INKSTER MI
48141-1089
US

V. Phone/Fax

Practice location:
  • Phone: 248-615-9730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: