Provider Demographics
NPI:1629532155
Name:STEEN, AMANDA L (FNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:STEEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:403 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-7702
Mailing Address - Country:US
Mailing Address - Phone:870-448-4489
Mailing Address - Fax:870-488-2016
Practice Address - Street 1:403 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:AR
Practice Address - Zip Code:72650-7702
Practice Address - Country:US
Practice Address - Phone:870-448-4489
Practice Address - Fax:870-488-2016
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily