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General NPI Number Information
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NPI Number | 1992590228
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Entity Type | Individual
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Provider Name | AMANDA J FRUGE AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 10001 S EASTERN AVE STE 403
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City | HENDERSON
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State | NV
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Zip | 89052-3908
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Country | US
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Telephone | 702-754-0622
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Fax | 702-476-2161
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Provider Business Mailing Address
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Address Line | 700 SHADOW LN STE 240
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City | LAS VEGAS
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State | NV
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Zip | 89106-4158
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Country | US
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Telephone | 702-384-0022
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 883491
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 883491
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License Number State | NV
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