Healthcare Provider Details

I. General information

NPI: 1033652201
Provider Name (Legal Business Name): AMY KRUTSCH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 CLINGMAN ST
GOLDSBORO NC
27534-2162
US

IV. Provider business mailing address

201 W RAINTREE LN
GOLDSBORO NC
27534-7369
US

V. Phone/Fax

Practice location:
  • Phone: 919-731-1000
  • Fax: 919-705-6568
Mailing address:
  • Phone: 919-705-1808
  • Fax: 919-705-6568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5009119
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number5009119
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: