Provider Demographics
NPI:1821794470
Name:KOHLHORST, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KOHLHORST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5355 E SNYDER RD
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:OH
Mailing Address - Zip Code:45326-9788
Mailing Address - Country:US
Mailing Address - Phone:937-570-9151
Mailing Address - Fax:
Practice Address - Street 1:5355 E SNYDER RD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:OH
Practice Address - Zip Code:45326-9788
Practice Address - Country:US
Practice Address - Phone:937-570-9151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle