AMANDA NICOLE LARSON (NPI# 1487955316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487955316 |
| Entity Type | Individual |
| Full Name | AMANDA NICOLE LARSON |
| Other Name | AMANDA NICOLE DANIELS |
| Credential | IDC |
| Practice Address |
500 Center St Building 22 Wahiawa HI 96786-3007 |
| Practice Telephone | 2287600296 |
| Mailing Telephone | 2287600296 |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2014-04-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457745986 | Amanda Larson | Nurse Practitioner | 420 12th St Se, Apt 16, Le Mars, IA 51031-2800 | 2015-03-23 |
| 1114568912 | Amanda Maria Larson | Counselor | 3292 County Road 220, Middleburg, FL 32068-4357 | 2019-10-02 |
| 1154887453 | Amanda Larson | Nurse Practitioner | 9000 W Wisconsin Ave, Milwaukee, WI 53226 | 2019-02-12 |
| 1285150060 | Amanda Larson | Physician Assistant | 2401 S 31st St, Temple, TX 76508-0001 | 2017-08-14 |
| 1922454727 | Amanda Larson | Occupational Therapist | 742 Sterbenz Dr, Hudson, WI 54016-8327 | 2016-05-11 |
| 1275914913 | Amanda Larson | Physical Therapist | 1977 Dewar Dr Ste J, Rock Springs, WY 82901-5757 | 2015-06-17 |
| 1053729327 | Amanda Larson | Registered Nurse | 5801 Crossings Blvd, Antioch, TN 37013-3130 | 2014-07-30 |
| 1609292713 | Amanda Larson | Psychologist | 1009 44th St Sw, 103, Wyoming, MI 49509 | 2014-03-13 |
| 1063789006 | Amanda Larson | Rehabilitation Practitioner | 4900 Serrania Ave, Woodland Hills, CA 91364-3301 | 2011-11-18 |
| 1336464544 | Amanda Celest Roof Larson | Orthopaedic Surgery | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2010-03-30 |
| Street Address |
500 CENTER ST BUILDING 22 |
| City | WAHIAWA |
| State | HI |
| Zip Code | 96786-3007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801421870 | Macy Tiatti Coleman | Student in an Organized Health Care Education/Training Program | 683 Waianae Ave, Schofield Barracks, HI 96786 | 2020-03-10 |
| 1063078467 | Jacqueline Tommila | Registered Nurse | Wai'anae & Ayres Ave, Wahiawa, HI 96786 | 2019-05-13 |
| 1578126157 | Shantelle Caliboso Bautista | Registered Nurse | Wheeler Army Field, Wahiawa, HI 96786 | 2019-04-18 |
| 1679136246 | Dorinda A Ventura | Licensed Practical Nurse | 1 Wheeler Aaf Wahiawa, Hi 96786, Wahiawa, HI 96786 | 2019-04-18 |
| 1659853950 | Archnaben Patel | Physician Assistant | 3399 Glennan St, Wahiawa, HI 96786 | 2018-09-04 |
| 1245720564 | Zi Xiang Liu | Physician Assistant | 3399 Glennan Street, Schofield Barracks, HI 96786 | 2018-05-11 |
| 1417445503 | Kristine Wong | Occupational Therapist | 1034 Kilani Ave Ste 109, Wahiawa, HI 96786 | 2018-04-25 |
| 1467964528 | Hope Treatment Services | Counselor | 360 California Avenue, Wahiawa, HI 96786 | 2017-10-30 |
| 1881103919 | Testiny K J Mailo | Assistant Behavior Analyst | 1046 Eho Eho Avenue, #326, Wahiawa, HI 96786 | 2017-09-20 |
| 1982121059 | Salvador Mireles Thorn | Physician Assistant | U.S. Army Health Clinic Sb, Building 683, Schofield Barracks, HI 96786 | 2017-08-29 |
| Find all providers in zip 96786 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518201953 | Michael Keonisabino Aperto-apodaca | Military Health Care Provider | 6844 Ormoc St, Wahiawa, HI 96786-3048 | 2012-11-26 |
| 1346423324 | Michael Duane Smaltz | Military Health Care Provider | 55a Savo Dr, Wahiawa, HI 96786-3001 | 2007-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205441888 | William Andrew Fitzpatrick | Military Health Care Provider | Bldg 6905, Mcbh, HI 96734 | 2020-09-10 |
| 1215549670 | Joseph Frabotta | Military Health Care Provider | 6894r Mokapu Rd, Kailua, HI 96734 | 2020-08-18 |
| 1508484882 | David Jason Brown | Military Health Care Provider | 6255 Kaawa St, Kailua, HI 96734-4984 | 2020-07-13 |
| 1134759715 | David Maldonado Santiago | Military Health Care Provider | 590 Moffet St, Jbphh, HI 96853-5168 | 2020-01-22 |
| 1003325366 | Justin Hesse | Military Health Care Provider | Building 17 Bishop Point, Pearl Harbor, HI 96860 | 2017-09-29 |
| 1649796244 | Joshua I White | Military Health Care Provider | Bldg 4078 Harris Rd., Mcbh Kaneohe Bay, HI 96863 | 2017-08-16 |
| 1104290519 | Carlton Jacob Maughan | Military Health Care Provider | Bldg 17 Bishops Point, Pearl Harbor, HI 96860 | 2015-11-23 |
| 1811363120 | Timothy Layton | Military Health Care Provider | 1016 Ulupau Loop, Kailua, HI 96734-4772 | 2015-08-20 |
| 1700263001 | Daniel Joseph Engelhardt | Military Health Care Provider | 5435 Kilmer Ln, Honolulu, HI 96818-3467 | 2015-05-06 |
| 1316350168 | Bryan Goodman | Military Health Care Provider | Bldg #1058, Mcbh Kaneohe Bay, HI 96863 | 2014-06-10 |
| Find all providers with the same taxonomy | ||||
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| 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.