Provider Demographics
NPI:1659105443
Name:KAPPNER, AMBER (BA)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:KAPPNER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-1953
Mailing Address - Country:US
Mailing Address - Phone:217-898-8336
Mailing Address - Fax:
Practice Address - Street 1:1410 MAPLE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-1953
Practice Address - Country:US
Practice Address - Phone:217-898-8336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist