MEDICARE: EMMA ASTER 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	163W00000X	Registered Nurse	4704363002	MI

General Provider Information

NPI Number	:	1346041795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA ASTER RN

Provider Business Mailing Address
First Line	:	3200 W LIBERTY RD STE A
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-9794
Country	:	US
Telephone Number	:	734-994-5858
Fax Number	:	734-994-4322

Provider Business Practice Location Address
First Line	:	3200 W LIBERTY RD STE A
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-9794
Country	:	US
Telephone Number	:	734-994-5858
Fax Number	:	734-994-4322

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

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	03/21/2025

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