Provider Demographics
NPI:1790575538
Name:SAUL, AMANDA
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:SAUL
Suffix:
Gender:
Credentials:
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:MOTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 BREMNER AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1197
Mailing Address - Country:US
Mailing Address - Phone:701-202-4080
Mailing Address - Fax:
Practice Address - Street 1:801 BREMNER AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1197
Practice Address - Country:US
Practice Address - Phone:701-202-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND3747P1801XMedicaid