Individual
MRS. AMANDA BROOKE DORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(806) 744-7223
(806) 740-3325
Mailing address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(806) 744-7223
(806) 740-3325
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
690681
TX
363LF0000X
Family Nurse Practitioner
Primary
AP117285
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161317100
FIRSTCARE
TX
05
—
1975922-01
—
TX
01
—
8Y8870
BCBS - GRACE CLINIC
TX
01
—
9242216
AETNA
TX
Enumeration date
08/29/2008
Last updated
12/01/2021
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