Individual
AMANDA A. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN
Contact information
Practice address
320 EBAUGH ST, GLENWOOD, IA 51534-1811
(712) 527-5204
(712) 527-9346
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A117293
IA
363LF0000X
Family Nurse Practitioner
111374
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508121658
—
IA
05
—
47068731712
—
NE
05
—
47068731777
—
NE
Enumeration date
07/05/2012
Last updated
09/17/2015
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