Amanda Lea Hicks, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

R047377 Issued in SD

Practice address

1000 Health Center Road
Kyle, SD 57752

Phone

(605) 455-8203

Fax

(605) 455-2808

NPI assigned

Sep 23, 2016

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

Other names 1

• Amanda Lea Woodard Former name

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": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1619426319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3934 PARK DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577020551",
            "telephone_number": "605-455-8203",
            "fax_number": "605-455-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER ROAD",
            "city": "KYLE",
            "state": "SD",
            "postal_code": "57752",
            "telephone_number": "605-455-8203",
            "fax_number": "605-455-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "AMANDA",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "SD",
            "license": "R047377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "WOODARD",
            "middle_name": "LEA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theresa Mary Friend, CNM, MSN
• Barbara Jeanne Fuller, PAC
• Louella Rose Garnette, RN.
• Jacob Godin, PHARM D
• Faye Hernandez, RN
• Lisa Michelle Hunter, PHARMD
• Indian Health Service-Kyle Health Center
• Christina Janis, LPC-MH
• Kristopher John Kelly, DDS
• Mary Elizabeth Kelly, CNM

• Ambulatory Care Registered Nurse in Kyle, SD
• Providers in Kyle, SD by specialty
• Ambulatory Care Registered Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.