Individual
AMANDA NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 S HOWARD ST, TUSTIN, MI 49688-5123
(231) 465-4165
(231) 465-4315
Mailing address
PO BOX 74, TUSTIN, MI 49688-0074
(231) 465-4165
(231) 465-4315
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601006530
MI
Other
Enumeration date
10/16/2012
Last updated
08/06/2019
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