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General NPI Number Information
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NPI Number | 1992401590
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Entity Type | Individual
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Provider Name | AMANDA MARIE NEARY RPH
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Gender | Female
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 13042 FAIRLANE ST
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City | LIVONIA
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State | MI
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Zip | 48150-1326
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Country | US
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Telephone | 734-762-6622
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Fax |
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Provider Business Mailing Address
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Address Line | 13414 BUTLER DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-3413
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Country | US
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Telephone | 586-747-5826
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5315213106
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License Number State | MI
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