Individual
AMANDA BETH KACK FLANNERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
12200 MIDDLE SET RD STE 100, EDEN PRAIRIE, MN 55344-5420
(952) 943-8200
(952) 943-8206
Mailing address
12200 MIDDLE SET RD STE 100, EDEN PRAIRIE, MN 55344-5420
(952) 943-8200
(952) 943-8206
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20111927
MN
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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