Amanda Evans, CNA
Individual provider Active NPI Nurse's Aide · Berkeley, MO
NPI 1831906189 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1831906189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 74277A (MO)
- Practice address
- 6017 Evergreen Blvd
Berkeley, MO 63134-2105 - Phone
- (314) 223-1792
- NPI assigned
- Dec 11, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74277A | MO | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 74277A | MO | Yes |
Addresses
Primary practice location
6017 Evergreen Blvd
Berkeley, MO 63134-2105
Mailing address
6017 Evergreen Blvd
Berkeley, MO 63134-2105
Phone (314) 223-1792
Other providers in Berkeley, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. 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.