Provider Demographics
NPI:1427604305
Name:LEFEBVRE, AMANDA K (ARNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:K
Last Name:LEFEBVRE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:IA
Mailing Address - Zip Code:51529-1214
Mailing Address - Country:US
Mailing Address - Phone:712-269-1980
Mailing Address - Fax:
Practice Address - Street 1:101 2ND ST
Practice Address - Street 2:
Practice Address - City:IDA GROVE
Practice Address - State:IA
Practice Address - Zip Code:51445-1401
Practice Address - Country:US
Practice Address - Phone:712-364-2300
Practice Address - Fax:712-364-2881
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA155592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily