Provider Demographics
NPI:1265719645
Name:HILL, AMANDA JULIENE (CNM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JULIENE
Last Name:HILL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:JULIENE
Other - Last Name:CRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3450 NE RALPH POWELL RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2361
Mailing Address - Country:US
Mailing Address - Phone:816-404-2170
Mailing Address - Fax:816-404-8014
Practice Address - Street 1:3450 NE RALPH POWELL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2361
Practice Address - Country:US
Practice Address - Phone:816-404-2170
Practice Address - Fax:816-404-8014
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-13
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011035997367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1265719645Medicaid
MO726D00007Medicare PIN