Provider Demographics
NPI:1154993814
Name:COX, AMANDA TONG (APRN)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:TONG
Last Name:COX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:TONG
Other - Last Name:NUECHTERLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5465 RENO CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2250
Mailing Address - Country:US
Mailing Address - Phone:775-327-4673
Mailing Address - Fax:775-327-4611
Practice Address - Street 1:5465 RENO CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2250
Practice Address - Country:US
Practice Address - Phone:775-327-4673
Practice Address - Fax:775-327-4611
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV842507363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner