Healthcare Provider Details

I. General information

NPI: 1326876426
Provider Name (Legal Business Name): AMY NICOLE D'ARISTOTILE NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W UNIVERSITY DR
ROCHESTER HILLS MI
48307-1878
US

IV. Provider business mailing address

17928 RODRIGUEZ DR
MACOMB MI
48042-1072
US

V. Phone/Fax

Practice location:
  • Phone: 248-390-6193
  • Fax:
Mailing address:
  • Phone: 586-871-9573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number4704271578
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: