Individual
AMANDA M. CRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
94 MAIN ST, CASSVILLE, MO 65625-1610
(417) 847-6000
Mailing address
PO BOX 504274, SAINT LOUIS, MO 63150-4274
(855) 420-7900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2009001274
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477792869
—
MO
01
—
431560263
TRICARE WEST
—
01
—
602630075
MEDICARE
MO
01
—
P00689756
RAILROAD MEDICARE
—
Enumeration date
02/10/2009
Last updated
07/21/2022
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