Provider Demographics
NPI:1417512419
Name:NEGRON, AMPHY LILIBET
Entity Type:Individual
Prefix:MRS
First Name:AMPHY
Middle Name:LILIBET
Last Name:NEGRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5716 MICHIGAN AVE STE 4100
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48210-3039
Mailing Address - Country:US
Mailing Address - Phone:313-758-9487
Mailing Address - Fax:
Practice Address - Street 1:5716 MICHIGAN AVE STE 4100
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210-3039
Practice Address - Country:US
Practice Address - Phone:313-963-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker