MEDICARE: AMELA DURGUTOVIC RN

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	163WM0705X	Medical-Surgical Registered Nurse	RN61251446	WA

General Provider Information

NPI Number	:	1558210435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELA DURGUTOVIC RN

Provider Business Mailing Address
First Line	:	4226 E 22ND AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-5522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4226 E 22ND AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-5522
Country	:	US
Telephone Number	:	509-551-2513
Fax Number	:

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

Provider Enumeration Date	:	01/24/2026
Last Update Date	:	01/24/2026

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