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General NPI Number Information
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NPI Number | 1609959246
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Entity Type | Individual
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Provider Name | AMY R KOEHN NNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 3594 SW 208TH ST
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City | PLATTSBURG
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State | MO
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Zip | 64477-9332
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Country | US
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Telephone | 317-965-8924
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Fax |
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Provider Business Mailing Address
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Address Line | 3594 SW 208TH ST
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City | PLATTSBURG
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State | MO
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Zip | 64477-9332
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Country | US
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Telephone | 317-965-8924
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 2023049467
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License Number State | MO
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