Healthcare Provider Details

I. General information

NPI: 1689597338
Provider Name (Legal Business Name): ANGELICA AMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18538 PALMER DR
MACOMB MI
48042-1731
US

IV. Provider business mailing address

18538 PALMER DR
MACOMB MI
48042-1731
US

V. Phone/Fax

Practice location:
  • Phone: 586-703-6077
  • Fax:
Mailing address:
  • Phone: 586-703-6077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number4704292830
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: