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NPI Code Detail

MEDICARE: AMANDA LYNN MAUK NP

MEDICARE: AMANDA LYNN MAUK NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner0029105OH

General Provider Information

NPI Number : 1023770070
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LYNN MAUK NP
Provider Business Mailing Address
First Line : 8996 BARLEY LOFT DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43240-6042
Country : US
Telephone Number : 614-570-0944
Fax Number :
Provider Business Practice Location Address
First Line : 4020 MORSE XING
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6037
Country : US
Telephone Number : 614-472-8496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2021
Last Update Date : 10/07/2021

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