Individual
MRS. AMANDA STAGGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1504 AVENUE K APT 112, DODGE CITY, KS 67801-7124
(843) 591-9848
Mailing address
1504 AVENUE K APT 112, DODGE CITY, KS 67801-7124
(843) 591-9848
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K02324995
DRIVERS LICENSE
KS
Enumeration date
08/22/2018
Last updated
08/22/2018
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