Provider Demographics
NPI:1497535207
Name:ASHFORD, CINNAMON I
Entity Type:Individual
Prefix:
First Name:CINNAMON
Middle Name:I
Last Name:ASHFORD
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 1:18251 ILENE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-1923
Mailing Address - Country:US
Mailing Address - Phone:248-727-8673
Mailing Address - Fax:
Practice Address - Street 1:18251 ILENE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-1923
Practice Address - Country:US
Practice Address - Phone:248-727-8673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider