Provider Demographics
NPI:1306876933
Name:NIGHTENGALE, AMY R (ARNP BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:NIGHTENGALE
Suffix:
Gender:F
Credentials:ARNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SUNNYVIEW LN
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3129
Mailing Address - Country:US
Mailing Address - Phone:406-751-5310
Mailing Address - Fax:406-751-3068
Practice Address - Street 1:310 SUNNYVIEW LN
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3129
Practice Address - Country:US
Practice Address - Phone:406-751-5310
Practice Address - Fax:406-751-3068
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45725363LF0000X
MT100877363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161532OtherBCBS
KS200337100AMedicaid
Q51829Medicare UPIN
KS200337100AMedicaid