Healthcare Provider Details

I. General information

NPI: 1902212699
Provider Name (Legal Business Name): AMY JOY DENYES GREEN AGACNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY JOY CONTOR RN

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 W UNIVERSITY DR SUITE 450
ROCHESTER MI
48307-1871
US

IV. Provider business mailing address

1135 W UNIVERSITY DR SUITE 450
ROCHESTER MI
48307-1871
US

V. Phone/Fax

Practice location:
  • Phone: 248-650-2400
  • Fax: 248-609-9097
Mailing address:
  • Phone: 248-650-2400
  • Fax: 248-609-9097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704227238
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: