Individual
MRS. AMANDA DIERKING BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, APRN
Contact information
Practice address
159 SAINT MATTHEWS AVE STE 8, LOUISVILLE, KY 40207-3137
(502) 888-1494
(502) 237-6600
Mailing address
159 SAINT MATTHEWS AVE STE 8, LOUISVILLE, KY 40207-3137
(502) 888-1494
(502) 237-6600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1120706
KY
363LF0000X
Family Nurse Practitioner
3006098
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3006098
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00976196
RAILROAD MEDICARE
KY
Enumeration date
04/10/2008
Last updated
10/08/2024
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