Amanda Simpler Seldomridge, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R209212 Issued in MD

Practice address

12191 Azalea CT
Worton, MD 21678-1470

Phone

(410) 708-7784

NPI assigned

Sep 11, 2023

Last updated

Sep 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1215714787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12191 AZALEA CT",
            "city": "WORTON",
            "state": "MD",
            "postal_code": "216781470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12191 AZALEA CT",
            "city": "WORTON",
            "state": "MD",
            "postal_code": "216781470",
            "telephone_number": "410-708-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELDOMRIDGE",
        "first_name": "AMANDA",
        "middle_name": "SIMPLER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R209212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Worton, MD
• Providers in Worton, MD by specialty
• Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.