Individual
MRS. AMRA BRISTINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2215 44TH ST SW, WYOMING, MI 49519-6439
(616) 252-8300
(616) 252-8460
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-8300
(616) 252-8460
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704296387
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699256784
—
MI
Enumeration date
08/27/2018
Last updated
10/09/2018
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