Healthcare Provider Details

I. General information

NPI: 1790195527
Provider Name (Legal Business Name): ASHLEE VICTORIA BARNES MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 N SAGINAW ST
PONTIAC MI
48342-2155
US

IV. Provider business mailing address

46 N SAGINAW ST
PONTIAC MI
48342-2155
US

V. Phone/Fax

Practice location:
  • Phone: 248-322-6747
  • Fax: 248-322-5787
Mailing address:
  • Phone: 248-322-6747
  • Fax: 248-322-5787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704275014
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: