Provider Demographics
NPI:1912327297
Name:OLMSCHENK, AMY (DO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:OLMSCHENK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1406 6TH AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1901
Mailing Address - Country:US
Mailing Address - Phone:320-251-2700
Mailing Address - Fax:320-656-7115
Practice Address - Street 1:1555 NORTHWAY DR
Practice Address - Street 2:STE. 200
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4555
Practice Address - Country:US
Practice Address - Phone:320-240-3157
Practice Address - Fax:320-240-3165
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN59957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine