Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 5601008800 | MI |
NPI | 1063994424 |
---|---|
Provider Name | Katelyn Elizabeth Amos |
First Address | Kalamazoo, MI 49007-4869 |
Second Address | Kalamazoo, MI 49007-4869 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2018 |
Last Update Date | 13/07/2021 |