Individual
MRS. AMANDA M BUSTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2680 W CENTRE AVE, PORTAGE, MI 49024-4828
(269) 324-2400
Mailing address
5827 CORPORATE WAY, WEST PALM BEACH, FL 33407-2000
(561) 844-9443
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
209.014881
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
4704419600
MI
Other
Enumeration date
01/20/2017
Last updated
02/26/2025
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