Amanda R Witlock

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R43988 Issued in ND

Practice address

1240 25TH St S
Fargo, ND 58103-2367

Phone

(701) 241-1360

NPI assigned

Jun 19, 2019

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• City of Fargo

  • Non-Surgical Family Planning Clinic/Center
  • Fargo, ND
  • NPI 1447335245
  NPD (past)
• City of Fargo

  • State or Local Public Health Clinic/Center
  • Fargo, ND
  • NPI 1891879839
  NPD (past)

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1801456074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 1ST ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032367",
            "telephone_number": "701-241-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITLOCK",
        "first_name": "AMANDA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R43988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Upham Wischer, NP
• Wisdom Tooth PLLC
• Cody Douglas Wise, PHARMD
• Ryan Wisecarver
• Wisteria Home Care
• Brenda M Witt, MSW
• Scott Raymond Witte, MA, ATC
• Anne K Witteman, LPCC, LMAC
• Stephanie Jo Wittman
• Gwen Witzel, NP-C

• Registered Nurse in Fargo, ND
• Providers in Fargo, ND by specialty
• Registered Nurse in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.