Healthcare Provider Details

I. General information

NPI: 1326925793
Provider Name (Legal Business Name): AMANDA K CAGLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 ATRIUM RD
FERNLEY NV
89408-7597
US

IV. Provider business mailing address

920 ATRIUM RD
FERNLEY NV
89408-7597
US

V. Phone/Fax

Practice location:
  • Phone: 775-842-8586
  • Fax:
Mailing address:
  • Phone: 775-842-8586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number20244479P
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: