Provider Demographics
NPI:1033340401
Name:KAMANN, ASHLEY EVE (OD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:EVE
Last Name:KAMANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:EVE
Other - Last Name:SCANTLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2860 E BELTLINE AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9704
Mailing Address - Country:US
Mailing Address - Phone:616-364-8484
Mailing Address - Fax:405-350-3072
Practice Address - Street 1:2860 E BELTLINE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9704
Practice Address - Country:US
Practice Address - Phone:616-363-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2623152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist