Individual
AMANDA RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-5111
(313) 993-2574
Mailing address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-1555
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704278661
MI
363L00000X
Nurse Practitioner
Primary
4704278661
MI
Other
Enumeration date
04/23/2016
Last updated
11/08/2023
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