Provider Demographics
NPI:1598163651
Name:VOLDNESS, AMANDA N (NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:VOLDNESS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:FLOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:1861 N PLEASANTS HWY # 101
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:WV
Practice Address - Zip Code:26170-8511
Practice Address - Country:US
Practice Address - Phone:681-612-1022
Practice Address - Fax:304-447-2556
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN. 361422363LF0000X
OHCOA.16845-NP363LF0000X
WV118610363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0114731Medicaid
WV3810028582Medicaid
OHH423580Medicare PIN
OHH423581Medicare PIN