Provider Demographics
NPI:1639565567
Name:HOUSEWRIGHT, ANASTASIA
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:HOUSEWRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANASTASIA
Other - Middle Name:
Other - Last Name:BAUSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:49285-9571
Mailing Address - Country:US
Mailing Address - Phone:517-442-2829
Mailing Address - Fax:
Practice Address - Street 1:4965 PITCH PINE LANE WEST
Practice Address - Street 2:APT 2B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48194
Practice Address - Country:US
Practice Address - Phone:517-442-2829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703103751164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse