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General NPI Number Information
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NPI Number | 1992161103
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Entity Type | Individual
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Provider Name | AMANDA NELSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 600 CAISSON HILL RD
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City | FORT RILEY
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State | KS
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Zip | 66442-7037
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Country | US
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Telephone | 785-239-7619
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Fax |
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Provider Business Mailing Address
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Address Line | 3933 FORREST CREEK CIR
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City | MANHATTAN
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State | KS
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Zip | 66503-7599
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Country | US
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Telephone | 308-201-0029
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-17157
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License Number State | KS
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