Basic Information
| Provider Information | |||||||||
| NPI: | 1285094060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARMOND | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12201 RENFERT WAY | ||||||||
| Address2: | STE. 225 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787585354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123396626 | ||||||||
| FaxNumber: | 5124253809 | ||||||||
| Practice Location | |||||||||
| Address1: | 12201 RENFERT WAY | ||||||||
| Address2: | STE. 225 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787585354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123396626 | ||||||||
| FaxNumber: | 5124253809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2016 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | AP130419 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LW0102X | AP130419 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 358248801 | 05 | TX | MEDICAID |