Doctor Name: | MS. AMY STUMP |
NPI Number: | 1093133654 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 111422 |
Business Practice Address: | 4111 4th Avenue Suite 50 Kearney, NE - 68845 |
Business Phone Number: | 3086980581 |
Business Fax Number: | |
Mailing Address: | 4111 4th Ave, Suite 50 KEARNEY |
State: | NE |
Postal Code: | 688452878 |
Phone Number: | 3086980581 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2014 |
NPI Last Update Date: | 04/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 111422 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |