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General NPI Number Information
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NPI Number | 1760045876
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Entity Type | Individual
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Provider Name | MRS. AMANDA ELLIS BIERMANN
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Gender | Female
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 1800 HERRING AVE E
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City | WILSON
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State | NC
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Zip | 27893-6727
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Country | US
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Telephone | 252-399-2246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 840
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City | PINETOPS
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State | NC
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Zip | 27864-0840
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Country | US
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Telephone | 528-137-1172
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5011687
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License Number State | NC
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