MEDICARE: AMY ELLEN KAUFFMAN WHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	NP01488	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013902170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ELLEN KAUFFMAN WHNP

Provider Business Mailing Address
First Line	:	3425 EXECUTIVE PKWY
Second Line	:	SUITE 200
City	:	TOLEDO
State	:	OH
Zip	:	43606-1326
Country	:	US
Telephone Number	:	419-475-4666
Fax Number	:

Provider Business Practice Location Address
First Line	:	3425 EXECUTIVE PKWY
Second Line	:	SUITE 200
City	:	TOLEDO
State	:	OH
Zip	:	43606-1326
Country	:	US
Telephone Number	:	419-475-4666
Fax Number	:	419-486-8855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	08/04/2015

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