MEDICARE: AMANDA HUNGATE

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
1	374700000X	Technician		NE

General Provider Information

NPI Number	:	1306654678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA HUNGATE

Provider Business Mailing Address
First Line	:	3802 REDICK AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68112-2966
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3802 REDICK AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68112-2966
Country	:	US
Telephone Number	:	531-299-2441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/18/2025

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Directions to “ AMANDA HUNGATE ” Practice Location

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