# MRS. AMY JO SHUPTRINE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1104382597
- **Gender:** F
- **Credential:** MSN, APRN, FNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 812655 | TX | — |
| 363L00000X | Nurse Practitioner | AP140582 | TX | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | AP140582 | TX | — |
| 363LA2200X | Adult Health Nurse Practitioner | AP140582 | TX | — |

## Other

- **Enumeration date:** 02/11/2019
- **Last updated:** 02/15/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 15390359 | TEXAS DRIVERS LICENSE | TX |