Healthcare Provider Details

I. General information

NPI: 1336442508
Provider Name (Legal Business Name): AMY LYNN ARNETT CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 12/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14930 LAPLAISANCE RD STE 127
MONROE MI
48161-3878
US

IV. Provider business mailing address

14930 LAPLAISANCE RD STE 127
MONROE MI
48161-3878
US

V. Phone/Fax

Practice location:
  • Phone: 734-243-2510
  • Fax: 734-243-0957
Mailing address:
  • Phone: 734-243-2510
  • Fax: 734-243-0957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4704245054
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: