Provider Demographics
NPI:1275218943
Name:KREFT, AMY JEAN (RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JEAN
Last Name:KREFT
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 LANDALE DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-7976
Mailing Address - Country:US
Mailing Address - Phone:121-989-8786
Mailing Address - Fax:
Practice Address - Street 1:241 LANDALE DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-7976
Practice Address - Country:US
Practice Address - Phone:121-989-8786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28230942A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily