Provider Demographics
NPI:1437349610
Name:TREON, AMANDA B (CNM)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:TREON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 SYMMES RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-1844
Mailing Address - Country:US
Mailing Address - Phone:513-893-4107
Mailing Address - Fax:513-863-3053
Practice Address - Street 1:1020 SYMMES RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-1844
Practice Address - Country:US
Practice Address - Phone:513-893-4107
Practice Address - Fax:513-863-3053
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12564-NM367A00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2991062Medicaid
OH2991062Medicaid
KY3403413Medicare PIN
OH2991062Medicaid
KY7100009210Medicaid