Healthcare Provider Details

I. General information

NPI: 1164368148
Provider Name (Legal Business Name): AMANDA NICOLE TRAMBLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 STUMPH RD APT 201
PARMA HEIGHTS OH
44130-2948
US

IV. Provider business mailing address

6420 STUMPH RD APT 201
PARMA HEIGHTS OH
44130-2948
US

V. Phone/Fax

Practice location:
  • Phone: 216-559-1739
  • Fax:
Mailing address:
  • Phone: 216-559-1739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number3747P1801X
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: