Provider Demographics
NPI:1699542415
Name:CARRENO, AMY (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CARRENO
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:KARN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13025 NW OAKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7319
Mailing Address - Country:US
Mailing Address - Phone:785-554-1423
Mailing Address - Fax:
Practice Address - Street 1:13025 NW OAKVIEW DR
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7319
Practice Address - Country:US
Practice Address - Phone:785-554-1423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018014638163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant