Healthcare Provider Details

I. General information

NPI: 1518886100
Provider Name (Legal Business Name): AMBER PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4164 KALAMAZOO AVE SE
GRAND RAPIDS MI
49508-3605
US

IV. Provider business mailing address

4164 KALAMAZOO AVE SE
GRAND RAPIDS MI
49508-3605
US

V. Phone/Fax

Practice location:
  • Phone: 616-432-4754
  • Fax:
Mailing address:
  • Phone: 616-432-4754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: