Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1346823911 | MI |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | XXXXXXXXXXXXX | MI |
NPI | 1346823911 |
---|---|
Provider Name | Amie Elizabeth Kremer |
First Address | Commerce Township, MI 48390-2759 |
Second Address | Flint, MI 48503-5902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2021 |
Last Update Date | 28/10/2021 |