Provider Demographics
NPI:1831974351
Name:MALONE, AMANDA C A
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:C A
Last Name:MALONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:C A
Other - Last Name:OSARCZUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:930 HAYES DR STE B
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5721
Mailing Address - Country:US
Mailing Address - Phone:785-565-0016
Mailing Address - Fax:
Practice Address - Street 1:930 HAYES DR STE B
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5721
Practice Address - Country:US
Practice Address - Phone:785-565-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82516363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily