1861943029 NPI number — MS. AMY CLAUNCH APRN

Table of content: MS. AMY CLAUNCH APRN (NPI 1861943029)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861943029 NPI number — MS. AMY CLAUNCH APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLAUNCH
Provider First Name:
AMY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861943029
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1401 HARRODSBURG RD
Provider Second Line Business Mailing Address:
C335
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40504-3751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-276-5355
Provider Business Mailing Address Fax Number:
859-276-5372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 HARRODSBURG RD
Provider Second Line Business Practice Location Address:
C335
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40504-3751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-276-5355
Provider Business Practice Location Address Fax Number:
859-276-5372
Provider Enumeration Date:
10/21/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  3010482 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3010482 . This is a "APRN LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: F061620286 . This is a "CERTIFICATION NUMBER FOR APRN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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