Individual
AMY LYNN ANTONICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
17 EXCHANGE ST W, STE 622, SAINT PAUL, MN 55102-1225
(651) 297-9141
Mailing address
6452 E CARONDELET DR STE 100, TUCSON, AZ 85710-2262
(715) 961-0232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
8031-33
WI
363LF0000X
Family Nurse Practitioner
338007
AZ
363LF0000X
Family Nurse Practitioner
Primary
8031-33
WI
Other
Enumeration date
10/12/2017
Last updated
04/22/2026
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