Provider Demographics
NPI:1629889506
Name:DEPINTO, AMY LYNN (NP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:DEPINTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 SCHROEDER RD
Mailing Address - Street 2:
Mailing Address - City:EAST JORDAN
Mailing Address - State:MI
Mailing Address - Zip Code:49727-8917
Mailing Address - Country:US
Mailing Address - Phone:734-395-9413
Mailing Address - Fax:
Practice Address - Street 1:2823 SCHROEDER RD
Practice Address - Street 2:
Practice Address - City:EAST JORDAN
Practice Address - State:MI
Practice Address - Zip Code:49727-8917
Practice Address - Country:US
Practice Address - Phone:734-395-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55599944207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine