Amanda Beth Kack Flannery, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

20111927 Issued in MN

Practice address

12200 Middle Set Rd Ste 100
Eden Prairie, MN 55344-5420

Phone

(952) 943-8200

Fax

(952) 943-8206

NPI assigned

Oct 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dakota Pediatrics, P.a.

  • Primary Care Clinic/Center
  • Inver Grove Heights, MN
  • NPI 1285943027
  NPD (past)

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1902182496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 MIDDLE SET RD STE 100",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445420",
            "telephone_number": "952-943-8200",
            "fax_number": "952-943-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 MIDDLE SET RD STE 100",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445420",
            "telephone_number": "952-943-8200",
            "fax_number": "952-943-8206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "AMANDA",
        "middle_name": "BETH KACK",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "20111927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Fisette
• Timothy Sebastian Fisher, MD
• Susan Ann Fishman, BSN, RN, CWOCN
• Shannon Fitzgerald
• Susan Kay Fix, C.P.N.P.
• Richard Bruce Flatz
• Cassandra Fleming
• Kari Noelle Fletcher, D.D.S
• Florena LLC
• Chelsea Flores, HIS

• Pediatric Nurse Practitioner in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.