Provider Demographics
NPI:1740620970
Name:ADAMS, AIMEE GAYLE (ANP-BC)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:GAYLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18309 BLUE HERON POINTE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-9261
Mailing Address - Country:US
Mailing Address - Phone:248-224-4000
Mailing Address - Fax:
Practice Address - Street 1:39201 7 MILE RD STE 140
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1079
Practice Address - Country:US
Practice Address - Phone:248-681-9541
Practice Address - Fax:248-681-9581
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266165363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health