Provider Demographics
NPI:1194359539
Name:HERRERA, AMANDA L (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 N 12TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-5172
Mailing Address - Country:US
Mailing Address - Phone:816-599-5111
Mailing Address - Fax:816-599-5959
Practice Address - Street 1:21 N 12TH ST STE 400
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-5172
Practice Address - Country:US
Practice Address - Phone:816-599-5111
Practice Address - Fax:816-599-5959
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1503004363A00000X
MO2024035203363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant