Healthcare Provider Details

I. General information

NPI: 1417740887
Provider Name (Legal Business Name): AMANDA NICOLE FINKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7774 DAYTON SPRINGFIELD RD STE B
FAIRBORN OH
45324-1957
US

IV. Provider business mailing address

1343 N FOUNTAIN BLVD STE 250
SPRINGFIELD OH
45504-1479
US

V. Phone/Fax

Practice location:
  • Phone: 937-340-6488
  • Fax: 937-340-6512
Mailing address:
  • Phone: 937-328-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05250218
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: