Provider Demographics
NPI:1285094060
Name:ARMOND, AMANDA NICOLE (NP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NICOLE
Last Name:ARMOND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 RENFERT WAY
Mailing Address - Street 2:STE. 225
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5354
Mailing Address - Country:US
Mailing Address - Phone:512-339-6626
Mailing Address - Fax:512-425-3809
Practice Address - Street 1:12201 RENFERT WAY
Practice Address - Street 2:STE. 225
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5354
Practice Address - Country:US
Practice Address - Phone:512-339-6626
Practice Address - Fax:512-425-3809
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130419363LG0600X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX358248801Medicaid