Blaine Amstadt
Individual provider Active NPI Registered Nurse · Monico, WI
NPI 1003136391 · NPPES record last updated Jun 9, 2010
Key facts
- NPI
- 1003136391
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 169353 (WI)
- Practice address
- 1645 Pederson St
Monico, WI 54501-7716 - Phone
- (715) 490-0570
- NPI assigned
- Jun 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 169353 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 169353 | WI | Yes |
Addresses
Primary practice location
1645 Pederson St
Monico, WI 54501-7716
Mailing address
1645 Pederson St
Monico, WI 54501-7716
Phone (715) 490-0570
Other providers in Monico, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.