Healthcare Provider Details

I. General information

NPI: 1437078540
Provider Name (Legal Business Name): AMANDA LING HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA ST. AMOUR

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 N WAVERLY RD STE 2A
LANSING MI
48917-2800
US

IV. Provider business mailing address

149 PLANTATION RIDGE DR STE 140
MOORESVILLE NC
28117-9175
US

V. Phone/Fax

Practice location:
  • Phone: 517-323-7986
  • Fax: 704-251-6746
Mailing address:
  • Phone: 704-360-4788
  • Fax: 704-251-6746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3502013357
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: