Provider Demographics
NPI:1114427259
Name:AMANDA'S HEARING CARE PLLC
Entity Type:Organization
Organization Name:AMANDA'S HEARING CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRENTICE
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:859-576-7376
Mailing Address - Street 1:1401 HARRODSBURG RD STE C212
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1751
Mailing Address - Country:US
Mailing Address - Phone:859-276-4327
Mailing Address - Fax:
Practice Address - Street 1:1401 HARRODSBURG RD STE C212
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1751
Practice Address - Country:US
Practice Address - Phone:859-276-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101838237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY101902OtherHEARING INSTRUMENT SPECIALIST
KY101838OtherHEARING INSTRUMENT SPECIALIST