Provider Demographics
NPI:1952646549
Name:CARNAHAN, ASHLEE D (RD)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEE
Middle Name:D
Last Name:CARNAHAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:D
Other - Last Name:UCKELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:9992 E US HIGHWAY 223
Mailing Address - Street 2:
Mailing Address - City:BLISSFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49228-9688
Mailing Address - Country:US
Mailing Address - Phone:517-605-4357
Mailing Address - Fax:
Practice Address - Street 1:4986 N ADAMS RD
Practice Address - Street 2:STE: E
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48306-5017
Practice Address - Country:US
Practice Address - Phone:248-475-4701
Practice Address - Fax:248-475-5777
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86005287133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered