Amanda Sue Allen

Individual provider Active NPI Attendant Care Provider · Walnut Grove, MO

NPI 1164073714 · NPPES record last updated Sep 25, 2019

Key facts

NPI
1164073714
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
Practice address
5530 S 47TH Rd
Walnut Grove, MO 65770-7503
Phone
(417) 741-2695
NPI assigned
Sep 25, 2019
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
Attendant Care Provider 3747A0650X Yes

Addresses

Primary practice location

5530 S 47TH Rd
Walnut Grove, MO 65770-7503

Mailing address

5530 S 47TH Rd
Walnut Grove, MO 65770-7503
Phone (417) 741-2695

Other providers in Walnut Grove, MO

All providers in Walnut Grove, MO · Attendant Care Provider in Missouri

Sources for this page

Verify at the official NPI Registry.