Healthcare Provider Details

I. General information

NPI: 1932011293
Provider Name (Legal Business Name): SUNSHINE FUNCTIONAL HEALING ADVANCED WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 HELEN AVE
PORTAGE MI
49002-1670
US

IV. Provider business mailing address

2122 HELEN AVE
PORTAGE MI
49002-1670
US

V. Phone/Fax

Practice location:
  • Phone: 269-626-3445
  • Fax: 262-326-5009
Mailing address:
  • Phone: 269-626-3445
  • Fax: 262-326-5009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMY MARIE READ
Title or Position: NURSE PRACTITIONER
Credential: AGACNP-BC
Phone: 843-424-1015