AMANDA BETH KACK FLANNERY CPNP NPI 1902182496

NPI Information

NPI: 1902182496
Provider Name: AMANDA BETH KACK FLANNERY, CPNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
12200 MIDDLE SET RD STE 100
EDEN PRAIRIE, MN
ZIP 55344
Phone: (952) 943-8200
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Amanda Beth Kack Flannery, CPNP is a pediatrics nurse practitioner in Eden Prairie, MN. Amanda Beth Kack Flannery, CPNP NPI is 1902182496. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12200 MIDDLE SET RD STE 100
EDEN PRAIRIE, MN
ZIP 55344-420
Phone: (952) 943-8200
Fax: (952) 943-8206

The enumeration date for this NPI number is 10/27/2011 and was last updated on 10/27/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	20111927	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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