Individual
AMY J CODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11899 M 32, ATLANTA, MI 49709-9374
(989) 785-4855
(989) 785-2267
Mailing address
PO BOX 427, HILLMAN, MI 49746-0427
(989) 354-2197
(989) 354-1952
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704311064
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MI
Enumeration date
09/08/2017
Last updated
12/05/2018
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