Provider Demographics
NPI:1043543747
Name:HERRICK, AMY LYNNE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNNE
Last Name:HERRICK
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Gender:F
Credentials:FNP-BC
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Other - Credentials:
Mailing Address - Street 1:PO BOX 67000
Mailing Address - Street 2:DEPARTMENT 272801
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-2728
Mailing Address - Country:US
Mailing Address - Phone:517-841-1431
Mailing Address - Fax:517-841-1432
Practice Address - Street 1:1201 E MICHIGAN AVE
Practice Address - Street 2:STE 300
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1852
Practice Address - Country:US
Practice Address - Phone:517-841-1431
Practice Address - Fax:517-841-1432
Is Sole Proprietor?:No
Enumeration Date:2009-09-12
Last Update Date:2024-02-01
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Provider Licenses
StateLicense IDTaxonomies
MI4704176663363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner