AMANDA WORTMAN (NPI# 1972139095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972139095 |
| Entity Type | Individual |
| Full Name | AMANDA WORTMAN |
| Credential | FNP |
| Practice Address |
24276 166th St, Airport Rd Eagle Butte SD 57625-1012 |
| Mailing Address |
101 Mercury St Pierre SD 57501-5672 |
| Practice Telephone | 6059647724 |
| Mailing Telephone | 6059399577 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-06-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CP001742 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497058077 | Amanda Freeman Wortman | Speech-Language Pathologist | 185 Charlois Blvd, Winston Salem, NC 27103-1521 | 2010-12-21 |
| Street Address |
24276 166TH ST, AIRPORT RD |
| City | EAGLE BUTTE |
| State | SD |
| Zip Code | 57625-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998359 | Jill M Marshall | Registered Nurse | 24279 166th St. Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
| 1871110890 | Stephen Andrew Williams | Registered Nurse | 24767 166th St, Eagle Butte, SD 57625 | 2020-06-26 |
| 1730706706 | Shannon Renee Brautigan | Registered Nurse | 24276 166th Street Airport Rd., Eagle Butte, SD 57625 | 2020-06-25 |
| 1598327827 | Lucy Manu | Pharmacist | 24276 166th Street; Airport Road, Eagle Butte, SD 57625 | 2019-07-08 |
| 1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
| 1063976025 | Jeff Dixon | Pharmacist | Cheyenne River Health Center 24276 Airport Rd., 166th S, Eagle Butte, SD 57625 | 2019-01-24 |
| 1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
| 1447765987 | Deidra Monique Hall | Nurse's Aide | 211 S Spiel Court, Eagle Butte, SD 57625 | 2017-12-06 |
| 1295271070 | Cree Iron Cloud | Registered Nurse | #24276 Airport Rd, Eagle Butte, SD 57625 | 2017-01-17 |
| 1922452531 | Holly Mattern | Registered Nurse | 24276 166th Street Airport Rd, Eagle Bute, SD 57625 | 2016-04-20 |
| Find all providers in zip 57625 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356384317 | Susan F Baker | Nurse Practitioner | Ihs Main Street, Eagle Butte, SD 57625-1012 | 2006-06-14 |
| 1033183595 | Kathleeen Kae Zambo | Nurse Practitioner | 24276 Airport Road, Eagle Butte, SD 57625 | 2006-02-13 |
| 1922380534 | Jessi Marri Steve | Nurse Practitioner | 317 Main Street, Eagle Butte, SD 57625 | 2011-09-10 |
| 1902927395 | Deleen Jean Kougl | Nurse Practitioner | 315 Main Street, Eagle Butte, SD 57625 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861000333 | Michelle Marie Mehrer | Nurse Practitioner | 307 St Joe St, Rapid City, SD 57701-2828 | 2020-07-21 |
| 1922625854 | Mindy Thompson | Nurse Practitioner | 2501 S Louis Ave, Sioux Falls, SD 57109-4601 | 2020-06-26 |
| 1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
| 1013567627 | Kasandra Wheeler | Nurse Practitioner | 1309 W 17th St Ste 1, Sioux Falls, SD 57104-4663 | 2019-09-16 |
| 1760040190 | Anna Gagliano | Nurse Practitioner | 1324 Panorama Cir, Rapid City, SD 57701-9221 | 2019-05-31 |
| 1508334772 | Sophia Lenter | Nurse Practitioner | 1325 Stewart Dr, Aberdeen, SD 57401-2682 | 2018-11-06 |
| 1457827834 | Katlyn Elizabeth Rostyne | Nurse Practitioner | 302 S Dumont Ave, Woonsocket, SD 57385 | 2018-10-23 |
| 1417422031 | Anna Bruce | Nurse Practitioner | 741 Mt View Rd, Rapid City, SD 57702-2540 | 2018-10-10 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1285110486 | Ryan Ross Rowe | Nurse Practitioner | 161 S. Main, Mission, SD 57555 | 2018-07-11 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE BUTTE |
| Zip Code | 57625 |
Please comment or provide details below to improve the information on AMANDA WORTMAN.
| 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.