MEDICARE: ASHLEY ANN MISIAK RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	4704299342	MI

General Provider Information

NPI Number	:	1063039394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ANN MISIAK RN

Provider Business Mailing Address
First Line	:	1035 W WASHINGTON AVE
Second Line	:
City	:	ALPENA
State	:	MI
Zip	:	49707-2929
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1063 US HIGHWAY 23 N
Second Line	:
City	:	ALPENA
State	:	MI
Zip	:	49707-1275
Country	:	US
Telephone Number	:	989-884-0380
Fax Number	:	989-884-0272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	04/17/2026

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Directions to “ ASHLEY ANN MISIAK RN” Practice Location

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