Provider Demographics
NPI:1215529748
Name:KOLTERMAN, AMANDA LYNN MARTIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LYNN MARTIN
Last Name:KOLTERMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-2628
Mailing Address - Country:US
Mailing Address - Phone:785-263-2229
Mailing Address - Fax:
Practice Address - Street 1:105 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2628
Practice Address - Country:US
Practice Address - Phone:785-263-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-101155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist