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General NPI Number Information
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NPI Number | 1811851066
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Entity Type | Individual
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Provider Name | AMANDA WARD RN
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Gender | Female
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1325 HIATT RD
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City | CLOVERDALE
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State | CA
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Zip | 95425-9764
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Country | US
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Telephone | 707-525-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 1165 MONTGOMERY DR
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City | SANTA ROSA
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State | CA
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Zip | 95405-4801
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Country | US
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Telephone |
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 95121756
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License Number State | CA
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