Individual
AMANDA BOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
30695 LITTLE MACK AVE STE 500, ROSEVILLE, MI 48066-1772
(313) 401-0256
Mailing address
30695 LITTLE MACK AVE STE 500, ROSEVILLE, MI 48066-1772
(313) 401-0256
(888) 212-3587
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704372464
MI
Other
Enumeration date
09/10/2019
Last updated
07/23/2026
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