Healthcare Provider Details

I. General information

NPI: 1144148271
Provider Name (Legal Business Name): AMANDA LYNN NOBLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6714 W UTOPIA RD
GLENDALE AZ
85308-5507
US

IV. Provider business mailing address

6714 W UTOPIA RD
GLENDALE AZ
85308-5507
US

V. Phone/Fax

Practice location:
  • Phone: 602-315-7356
  • Fax:
Mailing address:
  • Phone: 602-315-7356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN189729
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: