Healthcare Provider Details

I. General information

NPI: 1487464178
Provider Name (Legal Business Name): AMANDA TIFFANY MCGEE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37304 KINGS HWY
BEAVER ISLAND MI
49782-5134
US

IV. Provider business mailing address

27715 PAID EEN OGS RD
BEAVER ISLAND MI
49782-5163
US

V. Phone/Fax

Practice location:
  • Phone: 602-793-5349
  • Fax:
Mailing address:
  • Phone: 602-793-5349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704385445
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: