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General NPI Number Information
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NPI Number | 1255977369
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Entity Type | Individual
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Provider Name | MRS. AMANDA L PRINCE
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Gender | Female
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Dates
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Enumeration Date | 11/24/2019
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1539 FLORIDA RD STE 112
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City | DURANGO
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State | CO
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Zip | 81301-8062
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Country | US
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Telephone | 239-281-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 250 HEARTLAND ACRES
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City | DURANGO
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State | CO
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Zip | 81303-8855
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11004633
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.09972225-NO
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License Number State | CO
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