Healthcare Provider Details

I. General information

NPI: 1568847077
Provider Name (Legal Business Name): AMY MICHELLE KUTZ CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY MICHELLE PAYNE CNM

II. Dates (important events)

Enumeration Date: 07/26/2015
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 DEAUVILLE
MIDLAND TX
79706-2985
US

IV. Provider business mailing address

5801 DEAUVILLE APT 8212
MIDLAND TX
79706-3089
US

V. Phone/Fax

Practice location:
  • Phone: 707-343-8820
  • Fax:
Mailing address:
  • Phone: 916-908-9072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP130160
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: