Healthcare Provider Details

I. General information

NPI: 1629595186
Provider Name (Legal Business Name): ASHLEY MOYET NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 N LAPEER RD
OXFORD MI
48371-3610
US

IV. Provider business mailing address

8238 STAGHORN TRL
CLARKSTON MI
48348-4571
US

V. Phone/Fax

Practice location:
  • Phone: 248-969-7354
  • Fax: 248-628-8802
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05170505
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: