Individual
MRS. AMANDA JEVAHIRIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
25650 OUTER DR, LINCOLN PARK, MI 48146-2096
(313) 383-1897
(313) 383-6018
Mailing address
4700 SCHAEFER RD STE 340, DEARBORN, MI 48126-3743
(313) 561-5100
(313) 565-0309
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704300662
MI
363LF0000X
Family Nurse Practitioner
4704300662NSA210LV
MI
Other
Enumeration date
07/26/2021
Last updated
10/24/2024
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