Provider Demographics
NPI:1699021113
Name:BINDER, AMANDA L (APRN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:BINDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4855 E HIGHWAY 552 STE 1
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-9532
Mailing Address - Country:US
Mailing Address - Phone:606-552-0930
Mailing Address - Fax:877-367-7781
Practice Address - Street 1:4855 E HIGHWAY 552 STE 1
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-9532
Practice Address - Country:US
Practice Address - Phone:606-552-0930
Practice Address - Fax:877-669-0416
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007445363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK058142Medicare PIN
KYK058141Medicare PIN