Healthcare Provider Details

I. General information

NPI: 1619189032
Provider Name (Legal Business Name): AMANDA SUE MEANS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA SUE JONES

II. Dates (important events)

Enumeration Date: 05/06/2007
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 11TH ST
ELKINS WV
26241-3511
US

IV. Provider business mailing address

7 11TH ST
ELKINS WV
26241-3511
US

V. Phone/Fax

Practice location:
  • Phone: 304-630-6002
  • Fax: 304-630-6003
Mailing address:
  • Phone: 276-964-7439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number0222
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: