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General NPI Number Information
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NPI Number | 1073010419
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Entity Type | Individual
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Provider Name | AMANDA RAE MCVEY BSN, CCRN
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Gender | Female
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 1400 US HIGHWAY 61
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City | FESTUS
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State | MO
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Zip | 63028-4100
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Country | US
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Telephone | 636-933-1033
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Fax |
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Provider Business Mailing Address
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Address Line | 1122 VICKSBURG DR
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City | FESTUS
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State | MO
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Zip | 63028-3479
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Country | US
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Telephone | 314-608-0374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2018019047
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 2005022625
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License Number State | MO
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