Provider Demographics
NPI:1720768385
Name:COONTZ, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:COONTZ
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 1:7699 BRUNSWICK RD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-5748
Mailing Address - Country:US
Mailing Address - Phone:901-834-7310
Mailing Address - Fax:
Practice Address - Street 1:7699 BRUNSWICK RD
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-5748
Practice Address - Country:US
Practice Address - Phone:901-834-7310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula