Healthcare Provider Details

I. General information

NPI: 1770757767
Provider Name (Legal Business Name): JULIE ANN ASHLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2008
Last Update Date: 04/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15893 W MICHIGAN AVE
MARSHALL MI
49068-9578
US

IV. Provider business mailing address

15893 W MICHIGAN AVE
MARSHALL MI
49068-9578
US

V. Phone/Fax

Practice location:
  • Phone: 269-781-1191
  • Fax: 269-789-9622
Mailing address:
  • Phone: 269-781-1191
  • Fax: 269-789-9622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302411016
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: