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General NPI Number Information
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NPI Number | 1407430176
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Entity Type | Individual
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Provider Name | AMANDA BRITTANY MCCOMB
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Gender | Female
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 30 HUNTER LN
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City | CAMP HILL
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State | PA
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Zip | 17011-2400
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Country | US
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Telephone | 800-748-3243
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Fax |
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Provider Business Mailing Address
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Address Line | 5875 SILVER RIDGE DR
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City | PHELAN
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State | CA
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Zip | 92371-4084
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Country | US
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Telephone | 760-596-2790
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 95218535
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License Number State | CA
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