Provider Demographics
NPI:1992554679
Name:SWAIN, ASHLEY N (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:N
Last Name:SWAIN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34111 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4500
Mailing Address - Country:US
Mailing Address - Phone:734-301-1479
Mailing Address - Fax:
Practice Address - Street 1:41811 FORD RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3649
Practice Address - Country:US
Practice Address - Phone:734-301-1479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704359952363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology