MEDICARE: MRS. AMY CATHERINE ROY NPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704217807	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538166186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY CATHERINE ROY NPC

Provider Business Mailing Address
First Line	:	431 SWARTZ CT. STE. 200
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846
Country	:	US
Telephone Number	:	616-841-2615
Fax Number	:	616-828-1752

Provider Business Practice Location Address
First Line	:	431 SWARTZ CT. STE. 200
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846
Country	:	US
Telephone Number	:	616-841-2615
Fax Number	:	616-828-1752

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	03/29/2018

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