Healthcare Provider Details

I. General information

NPI: 1992776389
Provider Name (Legal Business Name): AMY FAGA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 SUPERIOR ST
WEBSTER CITY IA
50595-3146
US

IV. Provider business mailing address

1316 S MAIN ST
CLARION IA
50525-2019
US

V. Phone/Fax

Practice location:
  • Phone: 515-832-3332
  • Fax: 515-832-1114
Mailing address:
  • Phone: 156-029-8335
  • Fax: 319-343-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA095985
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: