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General NPI Number Information
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NPI Number | 1932011293
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Entity Type | Organization
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Legal Business Name | SUNSHINE FUNCTIONAL HEALING ADVANCED WELLNESS PLLC
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 2122 HELEN AVE
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City | PORTAGE
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State | MI
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Zip | 49002-1670
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Country | US
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Telephone | 269-626-3445
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Fax | 262-326-5009
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Provider Business Mailing Address
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Address Line | 2122 HELEN AVE
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City | PORTAGE
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State | MI
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Zip | 49002-1670
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Country | US
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Telephone | 269-626-3445
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Fax | 262-326-5009
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | AMY MARIE READ
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Credential | AGACNP-BC
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Telephone | 843-424-1015
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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 |
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License Number State |
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