Provider Demographics
NPI:1447596127
Name:IKELER, AMY REBEKAH (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:REBEKAH
Last Name:IKELER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2992 CEDAR KEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-1508
Mailing Address - Country:US
Mailing Address - Phone:248-420-5465
Mailing Address - Fax:
Practice Address - Street 1:2992 CEDAR KEY DR
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1508
Practice Address - Country:US
Practice Address - Phone:248-420-5465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704279777163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse