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General NPI Number Information
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NPI Number | 1770362055
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Entity Type | Individual
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Provider Name | AMI PATEL
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Gender | Female
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 306 W WASHINGTON AVE STE 102
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City | JACKSON
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State | MI
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Zip | 49201-2141
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Country | US
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Telephone | 517-435-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 1344 NAPA
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City | CANTON
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State | MI
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Zip | 48187-7721
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Country | US
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Telephone | 734-560-7806
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704349483
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License Number State | MI
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