Provider Demographics
NPI:1255900882
Name:BYRNES, ASHLEY ANNE (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANNE
Last Name:BYRNES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 838
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-0838
Mailing Address - Country:US
Mailing Address - Phone:616-447-4090
Mailing Address - Fax:616-447-4098
Practice Address - Street 1:4955 E BELTLINE AVE NE STE A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1097
Practice Address - Country:US
Practice Address - Phone:616-447-4090
Practice Address - Fax:616-447-4098
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704310599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily