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General NPI Number Information
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NPI Number | 1528490034
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Entity Type | Individual
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Provider Name | AMANDA HOERSTEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2013
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 4700 LAS VEGAS BLVD N BUILDING 1300
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City | NELLIS AFB
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State | NV
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Zip | 89191-6600
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Country | US
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Telephone | 702-653-5359
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 KELSO DUNES AVE APT 1522
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City | HENDERSON
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State | NV
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Zip | 89014-7869
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Country | US
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Telephone | 567-712-9463
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03232692-2
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18759
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License Number State | NV
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