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General NPI Number Information
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NPI Number | 1003288457
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Entity Type | Individual
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Provider Name | AMY ALTAMASH NP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 7443 JACKMAN RD
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City | TEMPERANCE
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State | MI
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Zip | 48182-9223
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Country | US
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Telephone | 734-850-0100
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Fax | 734-850-0112
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Provider Business Mailing Address
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Address Line | 7443 JACKMAN RD
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City | TEMPERANCE
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State | MI
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Zip | 48182-9223
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Country | US
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Telephone | 734-850-0100
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Fax | 734-850-0112
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704316352
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 361679
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001241905
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License Number State | VA
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