AMANDA GAIL DIVINE (NPI# 1336591049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336591049 |
| Entity Type | Individual |
| Full Name | AMANDA GAIL DIVINE |
| Credential | NURSE |
| Practice Address |
8725 E 32nd St N Wichita KS 67226-4008 |
| Practice Telephone | 3162011202 |
| Practice Fax Number | 3162011251 |
| Mailing Telephone | 3162011202 |
| Mailing Fax Number | 3162011251 |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
53-78308-011 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
2016013652 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7570 W 21st St N Ste 1006b, Wichita, KS 672051773 | 3162011202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417178195 | Amanda Nugent Divine | Counselor | 3780 Rosin Ct, Suite 110, Sacramento, CA 95834-1646 | 2007-05-01 |
| Street Address |
8725 E 32ND ST N |
| City | WICHITA |
| State | KS |
| Zip Code | 67226-4008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659592582 | Jamie Hannah Woo Page | Pediatrics | 8725 E 32nd St N, Wichita, KS 67226-4008 | 2007-05-01 |
| 1912557372 | Breanna Leigh Doenitz | Registered Nurse | 8725 E 32nd St N, Wichita, KS 67226-4008 | 2019-09-18 |
| 1245617406 | Michael Su | Pediatrics | 8725 E 32nd St N, Wichita, KS 67226-4008 | 2015-04-27 |
| 1255617833 | Redbud Pediatrics LLC | Pediatrics | 8725 E 32nd St N, Wichita, KS 67226-4008 | 2011-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111649 | Kansas Diabetes and Endocrinology Center LLC | Clinic/Center | 3161 N Webb Rd, Suite 200, Wichita, KS 67226 | 2018-10-25 |
| 1619474020 | Village Dentistry, Pa | Dentist | 2222 N. Greenwich, Suite 400, Wichita, KS 67226 | 2018-04-11 |
| 1861910408 | Lindsay Beth Kachelmeier | Marriage & Family Therapist | 6525 E Mainsgate, Wichita, KS 67226 | 2017-09-04 |
| 1659800084 | Doris Kimbrell | Clinical Nurse Specialist | 8200 East Thorn, Wichita, KS 67226 | 2017-06-08 |
| 1467986836 | Megan Elizabeth Couey | Counselor | 8623 E 32nd St. N, Suite 100, Wichita, KS 67226 | 2017-04-12 |
| 1306298922 | Wilson Yip | Dentist | 2222 N Greenwich Rd, Wichita, KS 67226 | 2016-07-07 |
| 1396102315 | Healthy Balance Center, LLC | Marriage & Family Therapist | 8100 E 22nd St. North, #1800-2, Wichita, KS 67226 | 2016-01-21 |
| 1851775142 | Cardiac Cath Lab of Wichita Lp | Clinic/Center | 3555 North Webb Rd., Suite A, Wichita, KS 67226 | 2015-07-16 |
| 1114334067 | Jane Crawford | Nurse Practitioner | 8623 E 32nd St N, Wichita, KS 67226 | 2014-07-11 |
| 1801202882 | Erin Kellie Jeffress | Occupational Therapy Assistant | 3500 N Rock Rd, Building 2200, Ste 101, Wichita, KS 67226 | 2014-07-10 |
| Find all providers in zip 67226 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336643691 | Jennifer Whitney Jensen | Nurse Practitioner | 1010 N Kansas St Ste 3054, Wichita, KS 67214-3124 | 2018-03-21 |
| 1255564357 | Stacey D. Howell | Nurse Practitioner | 550 N. Hillside, Ku Wichita Pediatric Hospitalists, Wichita, KS 67214 | 2009-08-24 |
| 1316004765 | Ruth H Oliverson | Nurse Practitioner | 9825 E Shannon Woods Cir, Wichita, KS 67226-4100 | 2007-01-03 |
| 1407869126 | Sharon R Tyson | Nurse Practitioner | 9825 E Shannon Woods, Wichita, KS 67226-4100 | 2006-08-14 |
| 1912999020 | Cynthia Marie Pinkerton | Nurse Practitioner | 3610 E Ross Pkwy, Wichita, KS 67210-1311 | 2005-08-16 |
| 1265437123 | Kathy A Hewett | Nurse Practitioner | 620 N Carriage Pkwy, Wichita, KS 67208-4501 | 2005-06-16 |
| 1033113576 | Jenny S Ecord | Nurse Practitioner | 3243 E Murdock St, Wichita, KS 67208-3052 | 2005-06-13 |
| 1124682349 | Amanda Walden | Nurse Practitioner | 144 S Hillside St, Wichita, KS 67211-2154 | 2019-04-23 |
| 1083002984 | Courtney Friesen | Nurse Practitioner | 550 N Hillside St, Building 1, 6th Floor, Wichita, KS 67214-4910 | 2014-12-30 |
| 1437570108 | Wendy Mosiman | Nurse Practitioner | 929 N Saint Francis St, Pediatrics, Wichita, KS 67214-3821 | 2013-12-26 |
| Find all providers in WICHITA | ||||
Please comment or provide details below to improve the information on AMANDA GAIL DIVINE.
| 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.