| Doctor Name: | AMY M FOLSOM |
| NPI Number: | 1053400457 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 2000150362 |
| Business Practice Address: | 1019 N Main St Sikeston, MO - 638015043 |
| Business Phone Number: | 5734727702 |
| Business Fax Number: | 5734727719 |
| Mailing Address: | 1008 N Main St, SIKESTON |
| State: | MO |
| Postal Code: | 638015044 |
| Phone Number: | 5734727406 |
| Fax Number: | 5734727475 |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 04/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2000150362 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |