Provider Demographics
NPI:1861279754
Name:ROSE, ASHLEY (MS, PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2221 CYNTHIA CT
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2201
Mailing Address - Country:US
Mailing Address - Phone:734-558-4768
Mailing Address - Fax:
Practice Address - Street 1:5701 BOW POINTE DR STE 300
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-5402
Practice Address - Country:US
Practice Address - Phone:248-792-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant