Provider Demographics
NPI:1184304917
Name:SOBCZAK, AMANDA NOEL (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:NOEL
Last Name:SOBCZAK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:MI
Mailing Address - Zip Code:48658-9164
Mailing Address - Country:US
Mailing Address - Phone:989-737-0461
Mailing Address - Fax:
Practice Address - Street 1:3250 E MIDLAND RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2835
Practice Address - Country:US
Practice Address - Phone:989-225-8983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704233197363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner