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NPI Code Detail

MEDICARE: AMANDA BETH WOMACK APRN

MEDICARE: AMANDA BETH WOMACK APRN
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
1363LA2200XAdult Health Nurse Practitioner136083MT

General Provider Information

NPI Number : 1235794918
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA BETH WOMACK APRN
Provider Business Mailing Address
First Line : 300 GARNET WAY
Second Line :
City : WARM SPRINGS
State : MT
Zip : 59756-9700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 GARNET WAY
Second Line :
City : WARM SPRINGS
State : MT
Zip : 59756-9700
Country : US
Telephone Number : 406-693-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2019
Last Update Date : 05/07/2019

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Directions to “ AMANDA BETH WOMACK APRN” Practice Location

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