Individual
MS. AMANDA J BALTIERRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
180 GRAFTON LN, BERRYVILLE, VA 22611-2576
(540) 955-2400
(540) 955-9765
Mailing address
PO BOX 112, 180 GRAFTON LANE, BERRYVILLE, VA 22611-0112
(540) 955-2400
(540) 955-9765
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024167997
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001726
—
WV
Enumeration date
03/21/2006
Last updated
01/03/2013
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