Provider Demographics
NPI:1841095643
Name:KYES, AMY ELIZABETH (APRN BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:KYES
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 KEPPEL LN
Mailing Address - Street 2:
Mailing Address - City:SAUGATUCK
Mailing Address - State:MI
Mailing Address - Zip Code:49453-9428
Mailing Address - Country:US
Mailing Address - Phone:616-403-7907
Mailing Address - Fax:
Practice Address - Street 1:3527 KEPPEL LN
Practice Address - Street 2:
Practice Address - City:SAUGATUCK
Practice Address - State:MI
Practice Address - Zip Code:49453-9428
Practice Address - Country:US
Practice Address - Phone:616-403-7907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704164264364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist