Provider Demographics
NPI:1194490904
Name:BARTELS, AMELIA LORRAINE
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:LORRAINE
Last Name:BARTELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 WOODSEDGE LN
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-3599
Mailing Address - Country:US
Mailing Address - Phone:248-392-1373
Mailing Address - Fax:
Practice Address - Street 1:426 AUDITORIUM RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-2600
Practice Address - Country:US
Practice Address - Phone:517-355-1855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program