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Individual

MRS. AMANDA KAY KIDDEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC, APRN

Contact information

Practice address
1207 W STATE ST STE M, ALLIANCE, OH 44601-4686
(330) 821-8407
(330) 821-8506
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 455-0374
(330) 453-6716

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.026067
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0385467
OH
Enumeration date
12/11/2019
Last updated
05/05/2025
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