Doctor Name: | AMANDA JEAN ROSS |
NPI Number: | 1831345107 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C |
License Number: | 5601005331 |
Business Practice Address: | 6227 Frankfort Hwy Benzonia, MI - 496168632 |
Business Phone Number: | 2318829661 |
Business Fax Number: | 2318829616 |
Mailing Address: | 6227 Frankfort Hwy, BENZONIA |
State: | MI |
Postal Code: | 496168632 |
Phone Number: | 2318829661 |
Fax Number: | 2318829616 |
NPI Enumeration Date: | 08/18/2008 |
NPI Last Update Date: | 08/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 5601005331 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |