Healthcare Provider Details

I. General information

NPI: 1891701561
Provider Name (Legal Business Name): AMY C HUELLE MPH, RD, LD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD. M.S. 2024
KANSAS CITY KS
66160
US

IV. Provider business mailing address

12 HOSPITAL DR STE B
YORK ME
03909-1030
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6022
  • Fax: 913-588-4060
Mailing address:
  • Phone: 913-588-6022
  • Fax: 913-588-4060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number36
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: