Individual
AMANDA K GROUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
3202 MCINTOSH CIR, SUITE 102, JOPLIN, MO 64804-3646
(417) 347-8355
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-8355
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2014028415
MO
363LF0000X
Family Nurse Practitioner
76443
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005022858
RN LICENSE NUMBER
MO
01
—
2014028415
FAMILY NURSE PRACTITIONER LICENSE NUMBER
MO
01
—
F0814211
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION NUMBER
—
Enumeration date
08/22/2014
Last updated
09/22/2014
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