Individual
AMANDA LANE ENDRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1132 E 12TH ST, DOUGLAS, AZ 85607-2337
(520) 364-2447
Mailing address
1132 E 12TH ST, DOUGLAS, AZ 85607-2337
(520) 364-2447
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN214956
AZ
Other
Enumeration date
08/04/2019
Last updated
08/04/2019
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