MEDICARE: MRS. AMANDA NICOLE RAMIREZ MSN, RN, NP-C

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	363LF0000X	Family Nurse Practitioner	95021040	CA

General Provider Information

NPI Number	:	1982339156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA NICOLE RAMIREZ MSN, RN, NP-C

Provider Business Mailing Address
First Line	:	7313 INDIO AVE
Second Line	:
City	:	YUCCA VALLEY
State	:	CA
Zip	:	92284-6045
Country	:	US
Telephone Number	:	760-668-1758
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 E TACHEVAH DR STE 3W105
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-5747
Country	:	US
Telephone Number	:	760-866-0024
Fax Number	:	760-866-0034

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

Provider Enumeration Date	:	07/20/2022
Last Update Date	:	07/20/2022

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