Provider Demographics
NPI:1386160539
Name:SQUAIR, AMY LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:SQUAIR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 S LATSON RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7643
Mailing Address - Country:US
Mailing Address - Phone:517-338-2360
Mailing Address - Fax:517-338-2361
Practice Address - Street 1:1225 S LATSON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7643
Practice Address - Country:US
Practice Address - Phone:517-338-2360
Practice Address - Fax:517-338-2361
Is Sole Proprietor?:No
Enumeration Date:2017-08-19
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704264098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily