Healthcare Provider Details

I. General information

NPI: 1003627977
Provider Name (Legal Business Name): NAOMI CATHERINE AMEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25631 LITTLE MACK AVE STE 205
SAINT CLAIR SHORES MI
48081-2108
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 586-443-2930
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704391514
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: