Individual
AMY E ETSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
905 HIGHWAY 161, BOWLING GREEN, MO 63334-2431
(573) 324-3333
(573) 324-3334
Mailing address
905 HIGHWAY 161, BOWLING GREEN, MO 63334-2431
(733) 243-3335
(573) 324-3334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2016018119
MO
363A00000X
Physician Assistant
310171
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM1497
RAILROAD MEDICARE
TN
Enumeration date
07/05/2006
Last updated
12/13/2018
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