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General NPI Number Information
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NPI Number | 1497427348
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Entity Type | Individual
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Provider Name | AMANDA R GONZALEZ RN, BSN, MSN
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Gender | Female
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Dates
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Enumeration Date | 09/29/2021
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 590 MEDICAL CENTER ROAD
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City | FORT HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-553-6228
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Fax |
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Provider Business Mailing Address
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Address Line | 113 RONGE ST N # 194
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City | ROY
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State | WA
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Zip | 98580
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Country | US
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Telephone | 971-218-0414
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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 | 61180410
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License Number State | WA
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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 | 1133397
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License Number State | TX
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