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Individual

AMANDA FAITH BOONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2006 E MAIN ST, MADISONVILLE, TX 77864-2216
(936) 225-4961
Mailing address
30000 FM RD 2978, 618, MAGNOLIA, TX 77354
(434) 996-8758

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1082967
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1082967
TEXAS BOARD OF NURSING
TX
Enumeration date
07/08/2022
Last updated
07/08/2022
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