AMANDA STARKS (NPI# 1376867598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376867598 |
| Entity Type | Individual |
| Full Name | AMANDA STARKS |
| Credential | CPNP |
| Practice Address |
1614 25th St Bedford IN 47421-5000 |
| Mailing Address |
Po Box 1329 Bloomington IN 47402-1329 |
| Practice Telephone | 8122770118 |
| Practice Fax Number | 8122770127 |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2016-03-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
71003206A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200975950 | 05 |
| Street Address |
1614 25TH ST |
| City | BEDFORD |
| State | IN |
| Zip Code | 47421-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598762528 | George W Sorrells Jr. | Pediatrics | 1614 25th St, Bedford, IN 47421-5000 | 2005-07-05 |
| 1083273825 | Cathern Amanda Pruett | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2019-06-06 |
| 1710544093 | Alisha Renee Stiles | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2019-05-22 |
| 1639691744 | Wyncel Joy Chan | Pediatrics | 1614 25th St, Bedford, IN 47421-5000 | 2017-07-10 |
| 1952785966 | Alexandra Freeman | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2015-07-20 |
| 1023457637 | Jamie R Bohnke | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2013-06-17 |
| 1154665313 | Rachael E Mullis | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2012-11-12 |
| 1295097913 | Kevin A Jones | Pediatrics | 1614 25th St, Bedford, IN 47421-5000 | 2012-06-08 |
| 1699060616 | Gregory Ervie Hanson | Pediatrics | 1614 25th St, Bedford, IN 47421-5000 | 2011-06-17 |
| 1215266739 | Pandu Ranga Sridhar | Pediatrics | 1614 25th St, Bedford, IN 47421-5000 | 2009-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114406303 | Leana Michelle Massimini | Speech-Language Pathologist | 3710 Kenneth Simpson Ln, Bedford, IN 47421 | 2018-08-09 |
| 1497246888 | Sara Lehr Corry | Counselor | 2325 Q St., Bedford, IN 47421 | 2018-05-22 |
| 1760737274 | Lisa Lynne Autry | Social Worker | 2125 16th Street, Bedford, IN 47421 | 2012-07-20 |
| 1285998153 | Reid Clipp Crosby | Obstetrics & Gynecology | 118woodhill Dr, Bedford, IN 47421 | 2012-06-26 |
| 1730453184 | Fields Chiropractic Inc | Chiropractor | 2418 W 16th St, Bedford, IN 47421 | 2012-03-02 |
| 1639461783 | Lori Wininger | Physical Therapy Assistant | 2137 16th Street, Bedford, IN 47421 | 2011-05-09 |
| 1871743716 | Union Optical and Eyecare Center, Inc. | Optometrist | 3343 Michael Ave, Bedford, IN 47421 | 2008-09-29 |
| 1326207176 | Ross Wright | Surgery | 179 Shawswick Road, Bedford, IN 47421 | 2008-06-06 |
| 1336320563 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1510 Clinic Dr, Bedford, IN 47421 | 2007-11-15 |
| 1306031992 | Assisted Living Concepts Inc | Assisted Living Facility | 3008 Shawnee Drive, South Bedford, IN 47421 | 2007-09-07 |
| Find all providers in zip 47421 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770114027 | Eileen Marie Hickey | Nurse Practitioner | 29 Webber Ave, Bedford, MA 01730-2212 | 2020-01-27 |
| 1841799376 | Julia Michelle Mckellar | Nurse Practitioner | 2213 Martin Dr, Bedford, TX 76021-6245 | 2018-02-11 |
| 1083273825 | Cathern Amanda Pruett | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2019-06-06 |
| 1710544093 | Alisha Renee Stiles | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2019-05-22 |
| 1952785966 | Alexandra Freeman | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2015-07-20 |
| 1023457637 | Jamie R Bohnke | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2013-06-17 |
| 1154665313 | Rachael E Mullis | Nurse Practitioner | 1614 25th St, Bedford, IN 47421-5000 | 2012-11-12 |
| 1598052201 | Patricia L Archilles | Nurse Practitioner | 2716 Tibbets Dr, Bedford, TX 76022-6915 | 2011-07-01 |
| 1407051436 | Allison L Townley | Nurse Practitioner | 2716 Tibbets Dr, Bedford, TX 76022-6915 | 2007-06-19 |
| 1679635882 | Mary H Levenstein | Nurse Practitioner | 41 North Rd, Suite 202, Bedford, MA 01730-1037 | 2006-12-14 |
| Find all providers in BEDFORD | ||||
Please comment or provide details below to improve the information on AMANDA STARKS.
| 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.