Healthcare Provider Details

I. General information

NPI: 1316972003
Provider Name (Legal Business Name): AMANDA ENGELKING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 23RD ST S
SARTELL MN
56377-4765
US

IV. Provider business mailing address

2000 23RD ST S
SARTELL MN
56377-4765
US

V. Phone/Fax

Practice location:
  • Phone: 320-202-8949
  • Fax: 320-202-0756
Mailing address:
  • Phone: 320-202-8949
  • Fax: 320-202-0756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number44683
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: