Provider Demographics
NPI:1639825219
Name:TROMLEY, AMANDA RYAN (AGPCNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RYAN
Last Name:TROMLEY
Suffix:
Gender:
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-5480
Mailing Address - Country:US
Mailing Address - Phone:800-451-0481
Mailing Address - Fax:810-985-5543
Practice Address - Street 1:1411 3RD ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-5480
Practice Address - Country:US
Practice Address - Phone:833-925-2900
Practice Address - Fax:810-985-5543
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704305780363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health