Provider Demographics
NPI:1437585825
Name:RACE, AMANDA LEIGH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LEIGH
Last Name:RACE
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Gender:F
Credentials:APRN
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Mailing Address - Street 1:59 CAVALIER BLVD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3901
Mailing Address - Country:US
Mailing Address - Phone:859-371-3232
Mailing Address - Fax:859-371-6943
Practice Address - Street 1:59 CAVALIER BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3901
Practice Address - Country:US
Practice Address - Phone:859-371-3232
Practice Address - Fax:859-371-6943
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
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Provider Licenses
StateLicense IDTaxonomies
KY3008289363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics