Individual
AMANDA J VANDEN WYNBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1606 GOLDEN ASPEN DR STE 105, AMES, IA 50010-8011
(515) 620-5892
(515) 620-5893
Mailing address
1103 RIDGETOP DR, HUXLEY, IA 50124-4704
(641) 485-8164
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A125509
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0227735
—
IA
01
—
C00000057738
BCBS OF IOWA
IA
Enumeration date
08/08/2017
Last updated
04/19/2021
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