MRS. AMANDA BRADY WATTERS GORMAN (NPI# 1124309430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124309430 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA BRADY WATTERS GORMAN |
| Other Name | AMANDA BRADY WATTERS |
| Credential | NP, RN |
| Practice Address |
2113 Highland Ridge Dr Phoenix MD 21131-1217 |
| Practice Telephone | 9175675260 |
| Practice Fax Number | 8443642618 |
| Mailing Telephone | 9175675260 |
| Mailing Fax Number | 8443642618 |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R214487 | MD | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R214487 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 174N00000X | Lactation Consultant, Non-RN | MD | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 092172600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 Potrero Avenue Dept. 6m, San Francisco, CA 94110 | 4152068457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649680505 | Amanda E Gorman | Pharmacist | 14169 S Bell Rd, Homer Glen, IL 60491-8464 | 2014-05-01 |
| 1942811138 | Amanda Leigh Gorman | Physical Therapist | 4200 Union Deposit Rd, Harrisburg, PA 17111-2801 | 2020-08-12 |
| 1285276584 | Amanda Gorman | Behavior Technician | 25115 Avenue Stanford Ste A100, Valencia, CA 91355-1290 | 2019-10-09 |
| 1821249251 | Amanda Rose Gorman | Specialist | 3101 W Ridge Rd, Building D, Rochester, NY 14626-3249 | 2008-10-03 |
| 1669691804 | Amanda Lea Gorman | Counselor | 3310 Perimeter Hill Dr, Nashville, TN 37211-4123 | 2007-04-25 |
| Street Address |
2113 HIGHLAND RIDGE DR |
| City | PHOENIX |
| State | MD |
| Zip Code | 21131-1217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366952657 | Ann Bennett | Lactation Consultant, Non-RN | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2017-10-02 |
| 1104343045 | Kristin Marie Pelletier | Registered Nurse | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2017-08-22 |
| 1740729466 | Gorman and Associates, LLC | Nurse Practitioner | 2113 Highland Ridge Dr, Phoenix, MD 21131-1217 | 2017-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114118387 | Mina Kirkova | Social Worker | 3009 Jackson Ridge Ct, Phoenix, MD 21131 | 2007-08-05 |
| 1629101381 | Kenneth Barry Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-13 |
| 1508999798 | Nancy Lee Sharoff | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131 | 2007-03-14 |
| 1093977134 | Amy Ruth Rakusin | Counselor | 10 Cross Creek Ct, Phoenix, MD 21131-1000 | 2008-06-30 |
| 1932493616 | Kenneth Sharoff, Phd Inc. | Social Worker | 1 Cross Creek Ct, Phoenix, MD 21131-1000 | 2011-05-31 |
| 1063608735 | Catherine Anderson North | Radiology | 1410 Phoenix Rd W, Phoenix, MD 21131-1024 | 2007-09-17 |
| 1528482643 | Charles Warnke | Speech-Language Pathologist | 13 Stonewood Ct, Phoenix, MD 21131-1116 | 2014-02-10 |
| 1699259580 | Keith Dibenedetto | Nurse Practitioner | 2617 Stockton Rd, Phoenix, MD 21131-1117 | 2018-09-18 |
| 1952775694 | Aileen Mccausland | Occupational Therapy Assistant | 2515 Stockton Rd, Phoenix, MD 21131-1127 | 2015-11-18 |
| 1700131919 | Gina Hoag | Social Worker | 15 Fairwood View Ct, Phoenix, MD 21131-1301 | 2012-07-13 |
| Find all providers in zip 21131 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083258354 | Stephenie Ann Lechuga | Nurse Practitioner | 3415 W Glendale Ave Ste 32a, Phoenix, AZ 85051-8485 | 2019-10-30 |
| 1215455605 | Shampa Nasreen | Nurse Practitioner | 2711 E Roosevelt St, Phoenix, AZ 85008-4946 | 2017-09-06 |
| 1306275581 | Melissa Kay Reichenbach | Nurse Practitioner | 444 W. Osborn Rd, Ste 301, Phoenix, AZ 85013-3896 | 2013-11-07 |
| 1831539410 | Michelle Lea Byers | Nurse Practitioner | 17624 North 31st Ave, Phoenix, AZ 85053 | 2013-06-27 |
| 1922356518 | April A Colon | Nurse Practitioner | 1919 E Thomas Road, Phoenix, AZ 85016-7710 | 2012-08-29 |
| 1043518707 | Lisette V Hill | Nurse Practitioner | 3802 N 53rd Avenue, Suite 160, Phoenix, AZ 85031 | 2011-03-04 |
| 1376853077 | Tara Leigh Pierce | Nurse Practitioner | 1661 E Camelback Rd Ste 170, Phoenix, AZ 85016-3921 | 2010-10-15 |
| 1144385634 | Deborah Biringer Anderson | Nurse Practitioner | 26224 N Tatum Blvd Ste 1, Phoenix, AZ 85050-7500 | 2006-12-26 |
| 1952408411 | Genny Marie Stiller | Nurse Practitioner | 1919 E. Thomas Road, Department of Hem/onc, Phoenix, AZ 85016 | 2006-09-19 |
| 1437256153 | Pamela K. Grant | Nurse Practitioner | 15420 N. 32nd Drive, Phoenix, AZ 85053-3998 | 2006-09-17 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.