Provider Demographics
NPI:1780294264
Name:SHIRLEY, ASHLEY D (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:D
Other - Last Name:CRANDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1042 S KANE RD
Mailing Address - Street 2:
Mailing Address - City:WEBBERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48892-9006
Mailing Address - Country:US
Mailing Address - Phone:517-245-8475
Mailing Address - Fax:
Practice Address - Street 1:1042 S KANE RD
Practice Address - Street 2:
Practice Address - City:WEBBERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48892-9006
Practice Address - Country:US
Practice Address - Phone:517-245-8475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-09
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704289616363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner