MEDICARE: AMY WARE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	NPF95033138	CA

General Provider Information

NPI Number	:	1417839176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY WARE NP

Provider Business Mailing Address
First Line	:	325 UNIVERSITY ST
Second Line	:
City	:	HEALDSBURG
State	:	CA
Zip	:	95448-4228
Country	:	US
Telephone Number	:	707-779-9691
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 MARK WEST SPRINGS RD
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-1436
Country	:	US
Telephone Number	:	707-779-9691
Fax Number	:	707-573-5360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	02/02/2026

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