Amanda Mae Walters
Individual provider Active NPI Case Manager/Care Coordinator · Tully, NY
NPI 1174822191 · NPPES record last updated Mar 16, 2011
Key facts
- NPI
- 1174822191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 38 State Street
Tully, NY 13159-0123 - Phone
- (607) 232-2961
- NPI assigned
- Mar 16, 2011
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
38 State Street
Tully, NY 13159-0123
Mailing address
PO Box 123
Tully, NY 13159-0123
Phone (607) 232-2961
Other providers in Tully, NY
All providers in Tully, NY · Case Manager/Care Coordinator in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.