Provider Demographics
NPI:1295467249
Name:SIEG, AMY (FNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:SIEG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 E HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-8028
Mailing Address - Country:US
Mailing Address - Phone:270-703-4360
Mailing Address - Fax:
Practice Address - Street 1:9159 TELECOM DR
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-3425
Practice Address - Country:US
Practice Address - Phone:270-703-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32974363LF0000X
TN221249163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse