Individual
AMANDA PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 W 25TH ST STE B4, KEARNEY, NE 68847-4473
(308) 708-2392
Mailing address
124 W 25TH ST STE B4, KEARNEY, NE 68847-4473
(308) 708-2392
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NE
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063750735
—
NE
Enumeration date
06/04/2018
Last updated
01/13/2020
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