Healthcare Provider Details

I. General information

NPI: 1518987296
Provider Name (Legal Business Name): AMY LYNN KUFAHL RNFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 HOSPITAL DR
WINDOM MN
56101-1287
US

IV. Provider business mailing address

2170 HOSPITAL DR
WINDOM MN
56101-1287
US

V. Phone/Fax

Practice location:
  • Phone: 507-831-2550
  • Fax: 507-831-5528
Mailing address:
  • Phone: 507-831-2550
  • Fax: 507-831-5528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR1386833
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: