| Amanda K Nixon Pa-c Pc | |
|
202 Howard St Tustin MI 49688-5123 | |
| (231) 465-4165 | |
| (231) 465-4315 |
| Full Name | Amanda K Nixon Pa-c Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 202 Howard St, Tustin, Michigan |
| Authorized Official Name and Position | Amanda K Nixon (OWNER) |
| Authorized Official Contact | 2314654165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda K Nixon Pa-c Pc Po Box 74 Tustin MI 49688-0074 Ph: (231) 465-4165 | Amanda K Nixon Pa-c Pc 202 Howard St Tustin MI 49688-5123 Ph: (231) 465-4165 |
| NPI Number | 1578072591 |
|---|---|
| Provider Enumeration Date | 09/21/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 4587935192 |
|---|---|
| Medicare Enrollment ID | O20171219000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578072591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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