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NPI Code Detail

MEDICARE: AMANDA JO ADAMS APRN

MEDICARE: AMANDA JO ADAMS 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
1363LF0000XFamily Nurse Practitioner53-75647KS

General Provider Information

NPI Number : 1790042661
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JO ADAMS APRN
Provider Business Mailing Address
First Line : 2090 W DARTMOUTH ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-6869
Country : US
Telephone Number : 913-356-8300
Fax Number :
Provider Business Practice Location Address
First Line : 2090 W DARTMOUTH ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-6869
Country : US
Telephone Number : 913-355-8300
Fax Number : 913-356-8711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2012
Last Update Date : 03/02/2020

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