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NPI Code Detail

MEDICARE: AMANDA LEIGH CAPPS RN

MEDICARE: AMANDA LEIGH CAPPS 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
1163W00000XRegistered Nurse28194886AIN

General Provider Information

NPI Number : 1841954906
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LEIGH CAPPS RN
Provider Business Mailing Address
First Line : 302 N JOHNSON RD
Second Line :
City : MOORESVILLE
State : IN
Zip : 46158-5504
Country : US
Telephone Number : 317-831-9033
Fax Number :
Provider Business Practice Location Address
First Line : 302 N JOHNSON RD
Second Line :
City : MOORESVILLE
State : IN
Zip : 46158-5504
Country : US
Telephone Number : 317-831-9033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2021
Last Update Date : 10/26/2021

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