Individual
MS. AUGUSTINA CHIOMA AMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
10 PETERBORO STREET, DETROIT, MI 48201
(313) 831-3160
(313) 309-1090
Mailing address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 831-3160
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704229170
MI
363L00000X
Nurse Practitioner
Primary
4704229170
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704229170
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704229170
STATE LICENSE NUMBER
MI
Enumeration date
08/31/2006
Last updated
06/10/2024
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