Provider Demographics
NPI:1629595186
Name:MOYET, ASHLEY (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:MOYET
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8238 STAGHORN TRL
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-4571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5625 WATER TOWER PL
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2671
Practice Address - Country:US
Practice Address - Phone:248-620-4265
Practice Address - Fax:248-620-4262
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF05170505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily