Individual
AMANDA S WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
904 5TH AVE NE, JAMESTOWN, ND 58401-3437
(701) 253-4000
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R39620
ND
363LF0000X
Family Nurse Practitioner
2013001306
MO
363LX0106X
Occupational Health Nurse Practitioner
Primary
R39620
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84313
—
ND
Enumeration date
01/17/2013
Last updated
10/02/2024
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