Provider Demographics
NPI:1427204346
Name:KNUTSON SHIMEK, AMY LYNN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:KNUTSON SHIMEK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:KNUTSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2401 DEMERS AVE - ALTRU BUSINESS CENTER
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201
Mailing Address - Country:US
Mailing Address - Phone:701-780-1891
Mailing Address - Fax:
Practice Address - Street 1:3165 DEMERS AVE - TRUYU AESTHETIC CENTER
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4049
Practice Address - Country:US
Practice Address - Phone:701-780-6623
Practice Address - Fax:701-780-6650
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR30877363LP2300X
MNR184263-6363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care