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: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MARKET ST
GLASGOW MO
65254-1053
US

IV. Provider business mailing address

108 MARKET ST
GLASGOW MO
65254-1053
US

V. Phone/Fax

Practice location:
  • Phone: 660-338-5909
  • Fax: 660-338-5903
Mailing address:
  • Phone: 660-338-3909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: