Healthcare Provider Details

I. General information

NPI: 1699572552
Provider Name (Legal Business Name): ALI AMANDA SEE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E BROADWAY
COLUMBIA MO
65201-5897
US

IV. Provider business mailing address

25762 HIGHWAY F
BRUNSWICK MO
65236-2226
US

V. Phone/Fax

Practice location:
  • Phone: 573-815-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2025005395
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025005395
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: