MEDICARE: AMANDA ROSE LOPER

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	374J00000X	Doula

General Provider Information

NPI Number	:	1700511334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ROSE LOPER

Provider Business Mailing Address
First Line	:	6707 KARNES LEAF
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-5882
Country	:	US
Telephone Number	:	502-799-3105
Fax Number	:

Provider Business Practice Location Address
First Line	:	6707 KARNES LEAF
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-5882
Country	:	US
Telephone Number	:	502-799-3105
Fax Number	:

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

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	07/18/2022

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Directions to “ AMANDA ROSE LOPER ” Practice Location

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