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NPI Code Detail

MEDICARE: MRS. AMANDA MARKUSSON FNP-BC

MEDICARE:  MRS. AMANDA  MARKUSSON  FNP-BC
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
1363LA2100XAcute Care Nurse PractitionerAPRN9453923FL
2363LF0000XFamily Nurse PractitionerAPRN9453923FL
3363LF0000XFamily Nurse Practitioner95001176CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811391949
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA MARKUSSON FNP-BC
Provider Business Mailing Address
First Line : 3861 SEPULVEDA BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4605
Country : US
Telephone Number : 310-450-2191
Fax Number :
Provider Business Practice Location Address
First Line : 3861 SEPULVEDA BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4605
Country : US
Telephone Number : 310-450-2191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 11/28/2022

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Directions to “ MRS. AMANDA MARKUSSON FNP-BC” Practice Location

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