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General NPI Number Information
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NPI Number | 1629094453
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Entity Type | Individual
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Provider Name | AMANDA M THOM APRN
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 208 S BURLINGTON AVE STE 108
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City | HASTINGS
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State | NE
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Zip | 68901
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Country | US
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Telephone | 402-463-6300
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Fax | 402-834-0665
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Provider Business Mailing Address
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Address Line | 208 S BURLINGTON AVE STE 108
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City | HASTINGS
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State | NE
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Zip | 68901-5943
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Country | US
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Telephone | 402-463-6300
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Fax | 402-834-0665
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110737
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License Number State | NE
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