AMANDA FONDREN (NPI# 1851792626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851792626 |
| Entity Type | Individual |
| Full Name | AMANDA FONDREN |
| Credential | FNP-C |
| Practice Address |
171 South St Caledonia MS 39740 |
| Mailing Address |
171 South St Caledonia MS 39740-8587 |
| Practice Telephone | 6628550080 |
| Practice Fax Number | 6628550082 |
| Mailing Telephone | 6628550080 |
| Mailing Fax Number | 6285500826 |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2018-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R858548 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7474 Highway 45 Alt N, West Point, MS 397737981 | 6624945863 | 6624945287 |
| Street Address |
171 SOUTH ST |
| City | CALEDONIA |
| State | MS |
| Zip Code | 39740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013426329 | Fig Leaf, LLC | Nurse Practitioner | 171 South St, Caledonia, MS 39740 | 2017-09-29 |
| 1528577012 | Lisa Jordan Hudson | Nurse Practitioner | 171 South St, Caledonia, MS 39740-8587 | 2017-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184056285 | Jrco, LLC | Specialist | 9692 Wolfe Rd, Caledonia, MS 39740 | 2013-07-31 |
| 1174723209 | Leslie Herndon Singley | Physical Therapist | 91 Gurlie Malone Rd., Caledonia, MS 39740 | 2007-07-18 |
| 1922056159 | Alvin Ray Beezley Jr. | Internal Medicine | 9692 Wolf Road, Caledonia, MS 39740 | 2006-05-04 |
| 1013294461 | Caledonia Pharmacy LLC | Pharmacy | 741 Main St, Caledonia, MS 39740-7609 | 2011-11-14 |
| 1104100858 | Joachim Yves Mckinney | Pharmacist | 4454 Cal Steens Rd, Caledonia, MS 39740-8677 | 2011-09-29 |
| 1770872459 | Misty S Glasgow | Occupational Therapist | 989 Flint Hill Rd, Caledonia, MS 39740-9026 | 2011-04-01 |
| 1811152317 | Jamie Boyd Whitney | Speech-Language Pathologist | 368 Martin Rd, Caledonia, MS 39740-9502 | 2008-07-23 |
| 1609309145 | Ashley Barksdale | Doula | 2327 Border Springs Rd, Caledonia, MS 39740-9524 | 2017-04-11 |
| 1194181057 | Blissful Moments Doula & Birth Services, LLC. | Doula | 268 Freeman Rd, Caledonia, MS 39740-9706 | 2016-01-07 |
| 1164670261 | Pioneer Health Services of Monroe County, Inc | Clinic/Center | 771 Main St, Caledonia, MS 39740-9999 | 2008-09-03 |
| Find all providers in zip 39740 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437606738 | Jodie Jo Slone | Nurse Practitioner | 5931 Section Line Rd, Caledonia, OH 43314-9459 | 2016-09-02 |
| 1851899959 | Jaime Burns | Nurse Practitioner | 9090 S Rodgers Ct Se Ste A, Caledonia, MI 49316-8052 | 2018-01-24 |
| 1568973345 | Nichole Anne Bundschuh | Nurse Practitioner | 9090 S Rodgers Ct Se Ste A, Caledonia, MI 49316-8052 | 2017-10-19 |
| 1528577012 | Lisa Jordan Hudson | Nurse Practitioner | 171 South St, Caledonia, MS 39740-8587 | 2017-09-27 |
| 1457766628 | Racheal Brooker | Nurse Practitioner | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2014-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AMANDA FONDREN.
| 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.