Provider Demographics
NPI:1093403990
Name:ARMSTRONG, VASHTI JAEL JAZMINE
Entity Type:Individual
Prefix:
First Name:VASHTI
Middle Name:JAEL JAZMINE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17326 BENTLER ST APT 101
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3987
Mailing Address - Country:US
Mailing Address - Phone:313-918-9503
Mailing Address - Fax:
Practice Address - Street 1:17326 BENTLER ST APT 101
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3987
Practice Address - Country:US
Practice Address - Phone:313-918-9503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty