Provider Demographics
NPI:1639929441
Name:STALEY, ASHLEY (CPR CERTIFIED)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:STALEY
Suffix:
Gender:F
Credentials:CPR CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:GLADWIN
Mailing Address - State:MI
Mailing Address - Zip Code:48624-1058
Mailing Address - Country:US
Mailing Address - Phone:989-313-6997
Mailing Address - Fax:
Practice Address - Street 1:1305 N SPRING ST LOT 112
Practice Address - Street 2:
Practice Address - City:GLADWIN
Practice Address - State:MI
Practice Address - Zip Code:48624-1072
Practice Address - Country:US
Practice Address - Phone:989-313-6997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide