Provider Demographics
NPI:1073083002
Name:SOLVEN, AMANDA JO (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JO
Last Name:SOLVEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:57950 LEAVENWORTH ST
Mailing Address - Street 2:
Mailing Address - City:MCCONNELL AFB
Mailing Address - State:KS
Mailing Address - Zip Code:67221-3505
Mailing Address - Country:US
Mailing Address - Phone:316-759-3600
Mailing Address - Fax:
Practice Address - Street 1:36TH MEDICAL GROUP
Practice Address - Street 2:UNIT 14010 BLDG. 26012
Practice Address - City:ANDERSEN AFB
Practice Address - State:GU
Practice Address - Zip Code:96543-4003
Practice Address - Country:US
Practice Address - Phone:671-366-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2024-08-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical