Provider Demographics
NPI:1487464178
Name:MCGEE, AMANDA TIFFANY (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:TIFFANY
Last Name:MCGEE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27715 PAID EEN OGS RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER ISLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49782-5163
Mailing Address - Country:US
Mailing Address - Phone:602-793-5349
Mailing Address - Fax:
Practice Address - Street 1:37895 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BEAVER ISLAND
Practice Address - State:MI
Practice Address - Zip Code:49782-5142
Practice Address - Country:US
Practice Address - Phone:602-793-5349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704385445163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse