Provider Demographics
NPI:1831271253
Name:STRUXNESS, AMANDA (OTR)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:STRUXNESS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ANDERSON DR APT 8
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-3562
Mailing Address - Country:US
Mailing Address - Phone:218-503-0171
Mailing Address - Fax:
Practice Address - Street 1:130 ANDERSON DR APT 8
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-3562
Practice Address - Country:US
Practice Address - Phone:218-503-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5033-026225X00000X
MN102418225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP45889OtherHEALTH PARTNERS
MN284L0STOtherBCBS
MN6404794OtherMEDICA
MN616055700Medicaid
MN6404794OtherMEDICA