Basic Information
| Provider Information | |||||||||
| NPI: | 1275780421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAWRY | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | N. | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5881 W 16TH ST STE B | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806342910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703361500 | ||||||||
| FaxNumber: | 9706522937 | ||||||||
| Practice Location | |||||||||
| Address1: | 5881 W 16TH ST STE B | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806342910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703361500 | ||||||||
| FaxNumber: | 9706522937 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2008 | ||||||||
| LastUpdateDate: | 02/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | APRN-1587 | HI | N | Other Service Providers | Midwife | 176B00000X | AP60030061 | WA | N | Other Service Providers | Midwife | 367A00000X | APN.0996913-CNM | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.