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Individual

AMANDA TANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1603 E 9 MILE RD, FERNDALE, MI 48220-2065
(248) 514-4955
Mailing address
1603 E 9 MILE RD, FERNDALE, MI 48220-2065
(248) 514-4955

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704327018
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704327018
MI

Other

Enumeration date
06/15/2022
Last updated
03/26/2026
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