Individual
AMANDA WORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
24276 166TH ST, AIRPORT RD, EAGLE BUTTE, SD 57625-1012
(605) 964-7724
Mailing address
101 MERCURY ST, PIERRE, SD 57501-5672
(605) 939-9577
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP001742
SD
Other
Enumeration date
03/20/2020
Last updated
06/29/2020
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