Provider Demographics
NPI:1720505167
Name:MERINO, AMANDA RAE (DNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:RAE
Last Name:MERINO
Suffix:
Gender:F
Credentials:DNP
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Mailing Address - Street 1:3726 N 153RD TER
Mailing Address - Street 2:
Mailing Address - City:BASEHOR
Mailing Address - State:KS
Mailing Address - Zip Code:66007-3008
Mailing Address - Country:US
Mailing Address - Phone:913-706-7434
Mailing Address - Fax:
Practice Address - Street 1:23401 PRAIRIE STAR PKWY STE B-300
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66227-7268
Practice Address - Country:US
Practice Address - Phone:913-677-6319
Practice Address - Fax:913-677-1540
Is Sole Proprietor?:No
Enumeration Date:2017-08-26
Last Update Date:2023-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS53-77832-041363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily