Ashlee Nicole Reardon, CRNA | |
22101 Moross Rd, Detroit, MI 48236-2148 | |
(313) 343-4000 | |
Not Available |
Full Name | Ashlee Nicole Reardon |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 22101 Moross Rd, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194421594 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 4704288246 (Michigan) | Primary |
Entity Name | Ascension St John Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598896995 PECOS PAC ID: 3173424082 Enrollment ID: O20040130000407 |
Mailing Address | Practice Location Address |
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Ashlee Nicole Reardon, CRNA 31150 Partridge Ln, Chesterfield, MI 48047-3075 Ph: (586) 709-7959 | Ashlee Nicole Reardon, CRNA 22101 Moross Rd, Detroit, MI 48236-2148 Ph: (313) 343-4000 |
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