| Doctor Name: | AMY G FAMINI |
| NPI Number: | 1104136696 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | ATP-000307 |
| Business Practice Address: | 3101 Se 14th St Bentonville, AR - 727124900 |
| Business Phone Number: | 4796312100 |
| Business Fax Number: | 4796360774 |
| Mailing Address: | 3101 Se 14th St, BENTONVILLE |
| State: | AR |
| Postal Code: | 727124900 |
| Phone Number: | 4796312100 |
| Fax Number: | 4796360774 |
| NPI Enumeration Date: | 10/18/2010 |
| NPI Last Update Date: | 10/18/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ATP-000307 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |