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General NPI Number Information
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NPI Number | 1598107542
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Entity Type | Individual
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Provider Name | AMANDA JEAN KUCHENREUTHER ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 804 KENYON RD
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City | FORT DODGE
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State | IA
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Zip | 50501-5742
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Country | US
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Telephone | 515-574-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 416 ELM ST
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City | ROCKWELL CITY
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State | IA
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Zip | 50579-1624
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Country | US
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Telephone | 515-571-4754
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A117926
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License Number State | IA
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