Individual
DR. AMY T KENWORTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 RIVERSIDE DR, WAUPACA, WI 54981-1943
(715) 258-1000
Mailing address
83 DEER VALLEY DR, LANDER, WY 82520-9780
(307) 335-8248
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
285-320
WI
207P00000X
Emergency Medicine Physician
6969A
WY
207R00000X
Internal Medicine Physician
35.053893
OH
207R00000X
Internal Medicine Physician
36143235
IL
207R00000X
Internal Medicine Physician
MD22847
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119346500
—
WY
Enumeration date
10/04/2006
Last updated
12/04/2020
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