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General NPI Number Information
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NPI Number | 1073094611
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Entity Type | Individual
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Provider Name | AMANDA THOMS CNP
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 2585 MIRACLE MILE STE 116
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-7562
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Country | US
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Telephone | 928-704-1221
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Fax | 928-704-1236
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Provider Business Mailing Address
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Address Line | PO BOX 3630
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City | FLAGSTAFF
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State | AZ
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Zip | 86003-3630
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Country | US
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Telephone | 928-522-9879
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CP001424
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 318122
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License Number State | AZ
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