Healthcare Provider Details

I. General information

NPI: 1952861874
Provider Name (Legal Business Name): AMORENA LILA TOMPKINS DNP, RN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY L TOMPKINS DNP, RN, NP-C

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30700 TELEGRAPH RD STE 15401
BINGHAM FARMS MI
48025-4524
US

IV. Provider business mailing address

PO BOX 6
FOSTORIA MI
48435-0006
US

V. Phone/Fax

Practice location:
  • Phone: 313-631-7878
  • Fax: 866-516-0753
Mailing address:
  • Phone: 989-795-2582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704268300
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704268300
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704268300
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704268300
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: