Provider Demographics
NPI:1770248783
Name:OSTROM, AMANDA M (CD(DONA))
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:OSTROM
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2877 SUMMERTREES BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-3911
Mailing Address - Country:US
Mailing Address - Phone:219-363-0332
Mailing Address - Fax:
Practice Address - Street 1:2877 SUMMERTREES BLVD
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-3911
Practice Address - Country:US
Practice Address - Phone:219-363-0332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula