Provider Demographics
NPI:1053711747
Name:SAULSBY-SMITH, AMY (ARNP, AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:SAULSBY-SMITH
Suffix:
Gender:F
Credentials:ARNP, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNITEDHEALTH GROUP
Mailing Address - Street 2:P.O. BOX 1459
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1459
Mailing Address - Country:US
Mailing Address - Phone:954-448-1463
Mailing Address - Fax:678-228-1475
Practice Address - Street 1:9900 BREN RD E
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9664
Practice Address - Country:US
Practice Address - Phone:954-448-1463
Practice Address - Fax:678-228-1475
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN180176363L00000X, 363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN180176OtherGA LICENSE
GA003162549AMedicaid
FLRN3397912OtherFL RN LICENSE
FLARNP3397912OtherFLNP LICENSE