Provider Demographics
NPI:1710853171
Name:BUCKENMEYER, AMY CAROL (PHD, MPH, CPH, CPNP-)
Entity type:Individual
Prefix:PROF
First Name:AMY
Middle Name:CAROL
Last Name:BUCKENMEYER
Suffix:
Gender:F
Credentials:PHD, MPH, CPH, CPNP-
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:CAROL
Other - Last Name:CORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, MPH, CPH, CPNP
Mailing Address - Street 1:400 N INGALLS ST # 4351
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-2003
Mailing Address - Country:US
Mailing Address - Phone:734-647-4554
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-936-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704395499163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse