Provider Demographics
NPI:1891701561
Name:HUELLE, AMY C (MPH, RD, LD, CDE)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:HUELLE
Suffix:
Gender:F
Credentials:MPH, RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HOSPITAL DR
Mailing Address - Street 2:STE B
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1030
Mailing Address - Country:US
Mailing Address - Phone:913-588-6022
Mailing Address - Fax:913-588-4060
Practice Address - Street 1:3901 RAINBOW BLVD.
Practice Address - Street 2:M.S. 2024
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6022
Practice Address - Fax:913-588-4060
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH36133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered