Provider Demographics
NPI:1134372907
Name:SHUBNELL, AMY LYNN (FNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:SHUBNELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9158
Mailing Address - Country:US
Mailing Address - Phone:269-673-2179
Mailing Address - Fax:269-673-6992
Practice Address - Street 1:305 THOMAS ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9158
Practice Address - Country:US
Practice Address - Phone:269-673-2179
Practice Address - Fax:269-673-6992
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704220712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily