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NPI Code Detail

MEDICARE: ASHLEY MARIE BADOUR

MEDICARE: ASHLEY MARIE BADOUR
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
1363L00000XNurse Practitioner4704329882MI
2363LF0000XFamily Nurse Practitioner4704329882MI

General Provider Information

NPI Number : 1265094544
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY MARIE BADOUR
Provider Business Mailing Address
First Line : 3051 KIESEL RD
Second Line :
City : BAY CITY
State : MI
Zip : 48706-2449
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3051 KIESEL RD
Second Line :
City : BAY CITY
State : MI
Zip : 48706-2449
Country : US
Telephone Number : 989-778-2888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2019
Last Update Date : 04/05/2024

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Directions to “ ASHLEY MARIE BADOUR ” Practice Location

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