Provider Demographics
NPI:1265157812
Name:BENTLEY, AMANDA CAYO (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAYO
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:CAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 M 139
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-3881
Mailing Address - Country:US
Mailing Address - Phone:855-869-6900
Mailing Address - Fax:269-757-7192
Practice Address - Street 1:800 M 139
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-3881
Practice Address - Country:US
Practice Address - Phone:855-869-6900
Practice Address - Fax:269-757-7192
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704335443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily