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General NPI Number Information
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NPI Number | 1376406769
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Entity Type | Individual
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Provider Name | AMANDA NICOLE STANGE
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 2660 W SUGNET RD
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City | MIDLAND
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State | MI
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Zip | 48640-2647
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Country | US
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Telephone | 989-832-0900
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Fax | 989-633-0349
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Provider Business Mailing Address
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Address Line | 5604 WOODBERRY CT
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City | MIDLAND
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State | MI
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Zip | 48640-6929
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Country | US
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Telephone | 989-948-1594
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704377118
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 2025047196
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License Number State | MI
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