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Contact Information

AMY J KNACKENDOFFEL, PA-C
801 W MAPLE ST
FARMINGTON, NM87401-5698
 Phone: 505-609-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for AMY J KNACKENDOFFEL · (Female)

NPI Number 1598333452
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 06/16/2021
Last updated 12/11/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CO License # PA.0006771
  • NM License # PA2024-0057
Hospital affiliation(s)
  • SUMMIT HEALTHCARE REGIONAL MEDICAL CENTER - (Acute Care)
    2200 SHOW LOW LAKE ROAD
    SHOW LOW, AZ 85901
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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