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Individual
MRS. AMANDA JO MAUM
Active
Individual
MRS. AMANDA JO MAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3014509
KY
363LF0000X
Family Nurse Practitioner
3014509
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100692180
—
KY
Enumeration date
08/07/2020
Last updated
04/01/2022
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