AMANDA MARIE FEDEWA (NPI# 1255930335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255930335 |
| Entity Type | Individual |
| Full Name | AMANDA MARIE FEDEWA |
| Practice Address |
1401 S Seward Meridian Pkwy Ste Ab Wasilla AK 99654-8312 |
| Practice Telephone | 9076313520 |
| Mailing Telephone | 9076313520 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | NA | 05 |
| Street Address |
1401 S SEWARD MERIDIAN PKWY STE AB |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-8312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437774668 | Autum Lynn Vigdahl | Technician | 1401 S Seward Meridian Pkwy Ste Ab, Wasilla, AK 99654-8312 | 2020-06-12 |
| 1902410178 | Brodrik Donald Rivers | Respite Care | 1401 S Seward Meridian Pkwy Ste Ab, Wasilla, AK 99654-8312 | 2020-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366040826 | Amanda Johnson | Technician | 1401 S Seward Meridian Pkwy # Ab, Wasilla, AK 99654-8312 | 2020-10-15 |
| 1437774668 | Autum Lynn Vigdahl | Technician | 1401 S Seward Meridian Pkwy Ste Ab, Wasilla, AK 99654-8312 | 2020-06-12 |
| 1518453927 | Alexandra Ross | Technician | 1401 S Steward Meridian Parkway, Wasilla, AK 99654 | 2018-07-09 |
| 1891860565 | Job Ready, Inc | Technician | 357 E Parks Hwy, Wasilla, AK 99654-7040 | 2006-11-21 |
| 1801411517 | Amy Ehrlinspiel | Technician | 1401 S Seward Meridian Pkwy # Abc, Wasilla, AK 99654-8312 | 2020-06-09 |
| 1932729373 | Stephanie Jean Nadeau | Technician | 1401 S Seward Meridian Pkwy, Wasilla, AK 99654-8312 | 2020-04-24 |
| 1720618853 | Michele K Tennis | Technician | 1401 S Seward Meridian Pkwy # Abc, Wasilla, AK 99654-8312 | 2020-01-16 |
| 1538652904 | Rebekah Louise Nicole Swan | Technician | 1401 S Seward Meridian Pkwy, Wasilla, AK 99654-8312 | 2018-06-11 |
| 1295228732 | Marion Sands | Technician | 1401 S Seward Meridian Pkwy, Wasilla, AK 99654-8312 | 2018-06-10 |
| 1386137883 | Norma Cobb | Technician | 1401 S Seward Meridian Pkwy, Wasilla, AK 99654-8312 | 2018-06-08 |
| Find all providers in WASILLA | ||||
Please comment or provide details below to improve the information on AMANDA MARIE FEDEWA.
| 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.