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General NPI Number Information
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NPI Number | 1619563954
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Entity Type | Individual
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Provider Name | AMBER MALIKOWSKI CNP
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Gender | Female
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Dates
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Enumeration Date | 12/20/2020
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Last Update Date | 12/20/2020
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Provider Practice Location Address
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Address Line | 300 S BRUCE ST
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City | MARSHALL
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State | MN
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Zip | 56258-1934
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Country | US
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Telephone | 507-532-9661
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Fax |
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Provider Business Mailing Address
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Address Line | 504 KENNEDY ST
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City | MINNEOTA
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State | MN
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Zip | 56264-9229
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Country | US
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Telephone | 320-282-4835
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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 | 7946
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License Number State | MN
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