AMANDA DANIELLE GREENE
NPI 1083183578
Physician Assistant - Medical in Petoskey, MI

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

Active since November 14, 2018

116 W MITCHELL ST, PETOSKEY, MI 49770(231) 347-7395 Get Directions Write a Review

NPPES record last updated: August 24, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 24, 2022, Nov 14, 2018 (2 updates tracked since 2018).

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About Amanda Danielle Greene NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA DANIELLE GREENE (NPI 1083183578) is an individual medical provider in Petoskey, Michigan, licensed in Michigan (5601009649) and active in the NPI registry since November 2018.

NPPES Registry Identity

NPI1083183578

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameAMANDA DANIELLE GREENE

Location Address116 W MITCHELL STPetoskey, MI 49770-2357

Mailing Address2111 Fantasy LnMidland, MI 48642-7407

Phone(231) 347-7395

Sole ProprietorYes

Enumeration DateNovember 14, 2018

Last NPPES UpdateAugust 24, 20222 updates tracked since enumeration

NPPES CertifiedAugust 24, 2022

✔ NPI 1083183578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in MI · 5601009649

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

116 W MITCHELL ST, Petoskey, MI 49770

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