Healthcare Provider Details

I. General information

NPI: 1689756595
Provider Name (Legal Business Name): AMANDA D. RYAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA D. RHODES D.O.

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 SKYLINE CIR STE A
CARLSBAD NM
88220-9842
US

IV. Provider business mailing address

1619 SKYLINE CIR STE A
CARLSBAD NM
88220-9842
US

V. Phone/Fax

Practice location:
  • Phone: 575-941-4400
  • Fax: 833-620-2406
Mailing address:
  • Phone: 575-941-4400
  • Fax: 833-620-2406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberOC10503
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA-1931-16
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: