Healthcare Provider Details

I. General information

NPI: 1306766530
Provider Name (Legal Business Name): AMY FUNK NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY GRAUSE

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 MERCY RD
OMAHA NE
68124-2319
US

IV. Provider business mailing address

25 N 3RD ST
MOVILLE IA
51039-7787
US

V. Phone/Fax

Practice location:
  • Phone: 402-398-6060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberK192540
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: