Provider Demographics
NPI:1346962016
Name:STRATMOEN, AMANDA (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:STRATMOEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 EUBANK BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3590
Mailing Address - Country:US
Mailing Address - Phone:505-292-8575
Mailing Address - Fax:505-292-8409
Practice Address - Street 1:3825 EUBANK BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3590
Practice Address - Country:US
Practice Address - Phone:505-292-8575
Practice Address - Fax:505-292-8409
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP70076363L00000X
NMCNP75538363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner