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General NPI Number Information
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NPI Number | 1891233821
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Entity Type | Individual
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Provider Name | AMANDA LIN CLEMONS DPN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 4156 EL INDIO HWY STE 150
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City | EAGLE PASS
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State | TX
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Zip | 78852-5976
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Country | US
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Telephone | 830-752-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 419 WOODHOUSE WAY
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City | FORT WORTH
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State | TX
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Zip | 76140-2013
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Country | US
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Telephone | 817-718-7318
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Fax | 817-612-3209
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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 | C-APN.0104456-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP133266
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201049
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License Number State | ND
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