Provider Demographics
NPI:1861770828
Name:NUNNELEE, AMY HAM (CCC-A)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:HAM
Last Name:NUNNELEE
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:RUTH
Other - Last Name:HAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-A
Mailing Address - Street 1:4604 W 65TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VLG
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1531
Mailing Address - Country:US
Mailing Address - Phone:816-651-5448
Mailing Address - Fax:
Practice Address - Street 1:20375 W 151ST ST STE 106
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5353
Practice Address - Country:US
Practice Address - Phone:913-312-1774
Practice Address - Fax:913-764-7502
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011019423231HA2500X
KS1948231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1948OtherAUDIOLOGY LICENSE
MO2011019423OtherAUDIOLOGY LICENSE