Provider Demographics
NPI:1013902170
Name:KAUFFMAN, AMY ELLEN (WHNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELLEN
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1326
Mailing Address - Country:US
Mailing Address - Phone:419-475-4666
Mailing Address - Fax:
Practice Address - Street 1:3425 EXECUTIVE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1326
Practice Address - Country:US
Practice Address - Phone:419-475-4666
Practice Address - Fax:419-486-8855
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP01488363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2320849Medicaid
Q30245Medicare UPIN
OH2320849Medicaid