Provider Demographics
NPI:1386017630
Name:KREBS, AMY LAUREN (NP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LAUREN
Last Name:KREBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743099
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3099
Mailing Address - Country:US
Mailing Address - Phone:855-494-7118
Mailing Address - Fax:919-967-6647
Practice Address - Street 1:1205 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-4511
Practice Address - Country:US
Practice Address - Phone:336-570-0344
Practice Address - Fax:336-570-0345
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5008155363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF0915244OtherAANP