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Individual
DR. AMIE LYNN ETTERS
Active
Individual
DR. AMIE LYNN ETTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
110902
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10871482
CAQH
MO
01
—
24313042
BLUE CROSS BLUE SHIELD KC
MO
01
—
2583144
AETNA
MO
Enumeration date
07/18/2006
Last updated
12/17/2014
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