Provider Demographics
NPI:1801785605
Name:HARRISON, AMANDA RENEE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4284
Mailing Address - Country:US
Mailing Address - Phone:406-640-0038
Mailing Address - Fax:
Practice Address - Street 1:1109 WOODVIEW DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4284
Practice Address - Country:US
Practice Address - Phone:406-640-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant