MEDICARE: MARIA ASHLEY BARRON

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	363LA2100X	Acute Care Nurse Practitioner	0000000000	MI

General Provider Information

NPI Number	:	1558022335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ASHLEY BARRON

Provider Business Mailing Address
First Line	:	9212 LAFAYETTE BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48209-4418
Country	:	US
Telephone Number	:	313-330-7287
Fax Number	:

Provider Business Practice Location Address
First Line	:	9212 LAFAYETTE BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48209-4418
Country	:	US
Telephone Number	:	313-330-7287
Fax Number	:

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

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	01/04/2022

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Directions to “ MARIA ASHLEY BARRON ” Practice Location

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