Provider Demographics
NPI:1194134924
Name:AKIENS, AMANDA M (CPHT)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:AKIENS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:3300 MUTUAL OF OMAHA PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68175-0002
Mailing Address - Country:US
Mailing Address - Phone:402-351-8431
Mailing Address - Fax:
Practice Address - Street 1:3300 MUTUAL OF OMAHA PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68175-0002
Practice Address - Country:US
Practice Address - Phone:402-351-8431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
560107010223989OtherPTCB