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Individual
MRS. AMANDA PATRICIA WAKIM
Active
Individual
MRS. AMANDA PATRICIA WAKIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
38366
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0063534
—
OH
01
—
2010009362
ANCC CERTIFICATION NUMBER
—
01
—
38366
WV RN LICENSE NUMBER
—
01
—
RN.287505
OHIO BOARD OF NURSING LICENSE NUMBER
—
Enumeration date
02/07/2011
Last updated
07/13/2020
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