Provider Demographics
NPI:1821798372
Name:AMIE KS FAMILY MEDICAL PRACTICE PLLC
Entity Type:Organization
Organization Name:AMIE KS FAMILY MEDICAL PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEAWMANEE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:325-864-3305
Mailing Address - Street 1:702 HICKORY ST STE B
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-5038
Mailing Address - Country:US
Mailing Address - Phone:325-701-8888
Mailing Address - Fax:325-701-8900
Practice Address - Street 1:702 HICKORY ST STE B
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5038
Practice Address - Country:US
Practice Address - Phone:325-701-8888
Practice Address - Fax:325-701-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty