| NPI | 1174747844 |
|---|---|
| Former Name | AMANDA NEWBANKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 932157) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45959) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2006004828) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2024-03-02 |