MEDICARE: AMANDA MARIE SPIES APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	1019891	TX

General Provider Information

NPI Number	:	1598360489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE SPIES APRN, FNP-C

Provider Business Mailing Address
First Line	:	4035 PEPPERWOOD DR
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-1287
Country	:	US
Telephone Number	:	513-502-1801
Fax Number	:

Provider Business Practice Location Address
First Line	:	802 N BONNIE BRAE ST STE 100
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-2417
Country	:	US
Telephone Number	:	940-514-1982
Fax Number	:

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	08/13/2022

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