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General NPI Number Information
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NPI Number | 1477133106
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Entity Type | Individual
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Provider Name | AMANDA WOLTERING
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 305 N HEATHERWILDE BLVD STE 140
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-4190
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Country | US
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Telephone | 512-522-6833
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 302173
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City | AUSTIN
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State | TX
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Zip | 78703-0037
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Country | US
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Telephone | 720-982-4476
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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 | 1045580
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License Number State | TX
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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 | 1045570
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 845345
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License Number State | TX
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