Amanda Corinne Kopp, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

148876-030 Issued in WI

Practice address

5590 Polworth St
Fitchburg, WI 53711-5484

Phone

(847) 602-9140

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1710947585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 ECHO VALLEY RD",
            "city": "BROOKLYN",
            "state": "WI",
            "postal_code": "535219448",
            "telephone_number": "608-215-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5590 POLWORTH ST",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115484",
            "telephone_number": "847-602-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP",
        "first_name": "AMANDA",
        "middle_name": "CORINNE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "148876-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38332100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliette V Koepp
• Catherine M Kolehmainen, BSN
• Carissa Jill Kolpek, OTR/L
• Laura Ann Konopacki, D.C.
• Kaitlan E Koplien
• Emily Kornell
• Catherine Anne Koss, M.S., CCC-SLP
• Stephanie S Kovach, SAC-IT
• Patricia S. Kraemer, M.D.
• Leah Krantz

• Registered Nurse in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.