Provider Demographics
NPI:1063750305
Name:ESTERLINE, AMY J (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:ESTERLINE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W. US 223
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-8479
Mailing Address - Country:US
Mailing Address - Phone:517-266-7788
Mailing Address - Fax:517-266-7755
Practice Address - Street 1:1801 W US HIGHWAY 223
Practice Address - Street 2:SUITE 120
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-8479
Practice Address - Country:US
Practice Address - Phone:517-266-7788
Practice Address - Fax:517-266-7755
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker