Healthcare Provider Details

I. General information

NPI: 1457262826
Provider Name (Legal Business Name): AMANDA BENDER CPRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 E MAIN ST
PERHAM MN
56573-1934
US

IV. Provider business mailing address

3951 STATE HIGHWAY 210 W
FERGUS FALLS MN
56537-4011
US

V. Phone/Fax

Practice location:
  • Phone: 218-671-0697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number10889
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: