Provider Demographics
NPI:1184165995
Name:READ, AMY MARIE (AGACNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:READ
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9085 LONG LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:SCOTTS
Mailing Address - State:MI
Mailing Address - Zip Code:49088-9762
Mailing Address - Country:US
Mailing Address - Phone:843-424-1015
Mailing Address - Fax:
Practice Address - Street 1:9085 LONG LAKE DR E
Practice Address - Street 2:
Practice Address - City:SCOTTS
Practice Address - State:MI
Practice Address - Zip Code:49088-9762
Practice Address - Country:US
Practice Address - Phone:843-424-1015
Practice Address - Fax:269-326-5009
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185984363LP0808X
MI4704276346363LA2100X
MDAC004971363LP0808X
MI363LP0808X363LP0808X
NY432506363LP0808X
SCA26394363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health