Provider Demographics
NPI:1790582708
Name:SOUDER, AMELIA
Entity type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:
Last Name:SOUDER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 N MILLBROOK AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2156
Mailing Address - Country:US
Mailing Address - Phone:559-776-8669
Mailing Address - Fax:
Practice Address - Street 1:8440 N MILLBROOK AVE APT 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2156
Practice Address - Country:US
Practice Address - Phone:559-776-8669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula