Provider Demographics
NPI:1467984070
Name:HERMSEN, AMANDA
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:HERMSEN
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 1:113 COMANCHE RD
Mailing Address - Street 2:
Mailing Address - City:FORT MEADE
Mailing Address - State:SD
Mailing Address - Zip Code:57741-1002
Mailing Address - Country:US
Mailing Address - Phone:605-720-7040
Mailing Address - Fax:
Practice Address - Street 1:111 NORTH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1163
Practice Address - Country:US
Practice Address - Phone:605-343-0650
Practice Address - Fax:605-342-3692
Is Sole Proprietor?:No
Enumeration Date:2017-04-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator