Provider Demographics
NPI:1447708094
Name:EADY, AMY JOY (NP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JOY
Last Name:EADY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JOY
Other - Last Name:BARNABO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3836 DEER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:MI
Mailing Address - Zip Code:49617-9638
Mailing Address - Country:US
Mailing Address - Phone:586-306-8770
Mailing Address - Fax:
Practice Address - Street 1:3836 DEER RIDGE TRL
Practice Address - Street 2:
Practice Address - City:BEULAH
Practice Address - State:MI
Practice Address - Zip Code:49617-9638
Practice Address - Country:US
Practice Address - Phone:586-306-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004918207K00000X, 207QA0000X, 363LF0000X
CANP95004918363LF0000X
VA0024188518363LF0000X
MI4704281115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine