AMY VIOLA PETRIE PAC NPI 1649386319

NPI Information

  • NPI: 1649386319
  • Provider Name: AMY VIOLA PETRIE, PAC
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 2002 S 11TH ST
    NILES, MI
    ZIP 49120
  • Phone: (269) 687-0200

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NPI Details

Amy Viola Petrie, PAC is a medical physician assistant in Niles, MI. Amy Viola Petrie, PAC NPI is 1649386319. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2002 S 11TH ST
NILES, MI
ZIP 49120-074
Phone: (269) 687-0200
Fax: (269) 684-0199

The enumeration date for this NPI number is 8/22/2006 and was last updated on 3/14/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical085002713ILLINOISNo
2363AM0700XPhysician AssistantMedical5601006305MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11649386319MEDICAIDMICHIGAN
2MI2051183MEDICARE PINMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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