Individual
AMY M KUKUCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1543 COUNTRY CLUB RD # A, FAIRMONT, WV 26554-1306
(304) 363-2273
Mailing address
1543 COUNTRY CLUB RD # A, FAIRMONT, WV 26554-1306
(304) 363-2273
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
123735
WV
363L00000X
Nurse Practitioner
APRN.CNP.021822
OH
Other
Enumeration date
10/19/2017
Last updated
08/28/2025
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