Provider Demographics
NPI:1003195025
Name:AMADO, AIDA E (MS, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:E
Last Name:AMADO
Suffix:
Gender:F
Credentials:MS, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10163 E JACOB AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-7086
Mailing Address - Country:US
Mailing Address - Phone:480-296-8849
Mailing Address - Fax:
Practice Address - Street 1:10163 E JACOB AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-7086
Practice Address - Country:US
Practice Address - Phone:480-296-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4152363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care