MEDICARE: AMANDA GILL BSN, RN

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	390200000X	Student in an Organized Health Care Education/Training Program	242103	AK

General Provider Information

NPI Number	:	1407787054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA GILL BSN, RN

Provider Business Mailing Address
First Line	:	PO BOX 220533
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99522-0533
Country	:	US
Telephone Number	:	907-244-9495
Fax Number	:

Provider Business Practice Location Address
First Line	:	3730 RHONE CIR STE 101
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5054
Country	:	US
Telephone Number	:	907-561-5152
Fax Number	:

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

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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