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General NPI Number Information
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NPI Number | 1235026105
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Entity Type | Individual
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Provider Name | AMY MARIE CERNIK CNP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1390 US HIGHWAY 61 STE G1000
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City | FESTUS
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State | MO
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Zip | 63028-4136
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Country | US
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Telephone | 636-933-7400
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Fax | 636-933-7403
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Provider Business Mailing Address
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Address Line | 1390 US HIGHWAY 61 STE G1000
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City | FESTUS
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State | MO
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Zip | 63028-4136
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Country | US
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Telephone | 636-933-7400
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Fax | 636-933-7403
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2021047308
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2025024112
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License Number State | MO
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