Amanda Dawn Sites

Individual provider Active NPI School Registered Nurse · Shenandoah Junction, WV

NPI 1003087750 · NPPES record last updated Mar 20, 2008

Key facts

NPI
1003087750
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
3178 (WV)
Practice address
4141 Flowing Springs Rd
Shenandoah Junction, WV 25442-4712
Phone
(304) 725-8491
NPI assigned
Mar 20, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 3178 WV Yes

Addresses

Primary practice location

4141 Flowing Springs Rd
Shenandoah Junction, WV 25442-4712

Mailing address

4141 Flowing Springs Rd
Shenandoah Junction, WV 25442-4712
Phone (304) 725-8491

Other identifiers

IdentifierTypeStateIssuer
9705102000MedicaidWV

Other providers in Shenandoah Junction, WV

All providers in Shenandoah Junction, WV · School Registered Nurse in West Virginia

Sources for this page

Verify at the official NPI Registry.