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General NPI Number Information
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NPI Number | 1922440197
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Entity Type | Individual
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Provider Name | AMANDA ANN FOX NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 7073 CLYO RD
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City | CENTERVILLE
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State | OH
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Zip | 45459-4816
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Country | US
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Telephone | 937-435-5857
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Fax | 937-912-4960
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Provider Business Mailing Address
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Address Line | 36123 SCHOOLCRAFT RD
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City | LIVONIA
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State | MI
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Zip | 48150-1216
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Country | US
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Telephone | 734-464-0887
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Fax | 734-402-0254
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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 | COA.14614-NP
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License Number State | OH
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