Individual
AMY LYNN WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
212 S MAIN ST STE A, BROOKLYN, MI 49230-9114
(517) 938-6085
(517) 938-6086
Mailing address
24 FRANK LLOYD WRIGHT DR # J2000, ANN ARBOR, MI 48105-9484
(734) 747-6766
(734) 222-3100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704307540
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704307540
MI LICENSE
MI
Enumeration date
11/06/2020
Last updated
02/14/2024
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