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General NPI Number Information
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NPI Number | 1932871837
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Entity Type | Individual
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Provider Name | AMANDA MARIE ROMAINE CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 3043 W INA RD STE 115
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City | TUCSON
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State | AZ
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Zip | 85741-2107
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Country | US
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Telephone | 520-797-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 5055 E BROADWAY BLVD STE A100
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City | TUCSON
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State | AZ
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Zip | 85711-3629
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Country | US
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Telephone | 520-327-0460
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 23188106
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 275393
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License Number State | AZ
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