Provider Demographics
NPI:1275285470
Name:DOHENY, AMY C
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:DOHENY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:C
Other - Last Name:RITCHIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:NE
Mailing Address - Zip Code:68879-0023
Mailing Address - Country:US
Mailing Address - Phone:308-870-1228
Mailing Address - Fax:
Practice Address - Street 1:108 FIRST ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:NE
Practice Address - Zip Code:68879-8121
Practice Address - Country:US
Practice Address - Phone:308-870-1228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver