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General NPI Number Information
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NPI Number | 1760041941
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Entity Type | Individual
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Provider Name | AMANDA BRITTNEY HATAMLEH CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 24 JOLIET ST
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City | DYER
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State | IN
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Zip | 46311-1705
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Country | US
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Telephone | 219-865-2141
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Fax |
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Provider Business Mailing Address
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Address Line | 8505 WHITE OAK AVE
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City | MUNSTER
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State | IN
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Zip | 46321-1924
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Country | US
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Telephone | 708-428-3857
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28184663A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28184663A
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License Number State | IN
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