Kenworthy, Amy T

Kenworthy, Amy T is an sole proprietor health care provider with primary practice located at 800 Riverside Dr , Waupaca WI 54981-1943. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Kenworthy, Amy T can be contacted via phone (715) 258-1000.

Contact Information

Primary practice address
800 Riverside Dr Waupaca WI 54981-1943
Phone: (715) 258-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 6969A Wyoming
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD22847 Maine
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35.053893 Ohio
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 36143235 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 285-320 Wisconsin

Profile Details

NPI number 1346335254
LBN Legal business name Kenworthy, Amy T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2006
Last updated Dec 4th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346335254 NPPES
Wyoming MEDICAID 119346500

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