Healthcare Provider Details

I. General information

NPI: 1194541128
Provider Name (Legal Business Name): AMANDA B BEST MICRO PIGMENTATION
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MANDEE BEST MICRO PIGMENTATION

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 BOX BUTTE AVE
ALLIANCE NE
69301-3344
US

IV. Provider business mailing address

416 BOX BUTTE AVE
ALLIANCE NE
69301-3344
US

V. Phone/Fax

Practice location:
  • Phone: 352-251-8502
  • Fax:
Mailing address:
  • Phone: 352-251-8502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number95
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: