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Individual

MS. AMY ELIZABETH NOLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
18101 OAKWOOD BLVD, ISU OBSERVATION UNIT, DEARBORN, MI 48124-4089
(313) 982-5770
(313) 982-5771
Mailing address
38935 ANN ARBOR RD, CREDENTIALING/PAYER CONTRACTING, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704165314
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12266448
CAQH
05
1902101314
MI
Enumeration date
01/14/2011
Last updated
02/22/2012
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