Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW395 | FL |
NPI | 1003403585 |
---|---|
Provider Name | Amanda Kay West |
First Address | Neptune Beach, FL 32266-5046 |
Second Address | Neptune Beach, FL 32266-5046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2020 |
Last Update Date | 30/12/2020 |