Provider Demographics
NPI:1962045393
Name:DEFRANCO, AMY JEANNE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:JEANNE
Last Name:DEFRANCO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JEANNE
Other - Last Name:SZCZEPANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:10927 NARROW WAY
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54616
Mailing Address - Country:US
Mailing Address - Phone:715-418-4279
Mailing Address - Fax:844-285-4399
Practice Address - Street 1:502 MAIN ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-1648
Practice Address - Country:US
Practice Address - Phone:715-284-2003
Practice Address - Fax:844-285-4399
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003566363LF0000X
FL11003566363LF0000X
WI10175-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100103102Medicaid