Provider Demographics
NPI:1255937298
Name:NEWELL, ASHLEY RAE (CPHT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RAE
Last Name:NEWELL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6019
Mailing Address - Country:US
Mailing Address - Phone:989-341-0739
Mailing Address - Fax:
Practice Address - Street 1:416 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3206
Practice Address - Country:US
Practice Address - Phone:989-671-0468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303015164183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician