Provider Demographics
NPI:1205695863
Name:HARRINGTON, AMY KATHRYN
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KATHRYN
Last Name:HARRINGTON
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 1:15483 FARNHAM AVE N
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-8547
Mailing Address - Country:US
Mailing Address - Phone:651-402-6960
Mailing Address - Fax:
Practice Address - Street 1:15483 FARNHAM AVE N
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-8547
Practice Address - Country:US
Practice Address - Phone:651-402-6960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty