Provider Demographics
NPI:1326226333
Name:WILBERDING, AMANDA MARGARET
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:MARGARET
Last Name:WILBERDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17491 W 16TH AVE
Mailing Address - Street 2:#314
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2574
Mailing Address - Country:US
Mailing Address - Phone:303-883-5374
Mailing Address - Fax:
Practice Address - Street 1:17491 W 16TH AVE
Practice Address - Street 2:#314
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2574
Practice Address - Country:US
Practice Address - Phone:303-883-5374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO514076376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide