Individual
AMY LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
417 E 35TH ST, KEARNEY, NE 68847-3033
(312) 508-9610
Mailing address
417 E 35TH ST, KEARNEY, NE 68847-3033
(312) 508-9610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
57576
NE
363LF0000X
Family Nurse Practitioner
Primary
113011
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114478112
MILITARY
—
Enumeration date
10/14/2016
Last updated
01/18/2022
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