Provider Demographics
NPI:1356407043
Name:MCLAUGHLIN, AMANDA R (WHNP, FNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:WHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 HORIZON ST
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1352
Mailing Address - Country:US
Mailing Address - Phone:972-691-0996
Mailing Address - Fax:
Practice Address - Street 1:5201 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7708
Practice Address - Country:US
Practice Address - Phone:214-590-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX657365363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155778703Medicaid
TX155778709Medicaid
TX155778711Medicaid
TX155778702Medicaid
TX155778705Medicaid
TX155778706Medicaid
TX155778708Medicaid
TX155778710Medicaid
TX155778704Medicaid
TX155778707Medicaid