Provider Demographics
NPI:1508690447
Name:DEAN, AMANDA L
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 TIMBERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1659
Mailing Address - Country:US
Mailing Address - Phone:440-396-8624
Mailing Address - Fax:
Practice Address - Street 1:5001 TIMBERVIEW DR
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-1659
Practice Address - Country:US
Practice Address - Phone:440-396-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult Companion