Provider Demographics
NPI:1851368617
Name:HOSTETLER, AMANDA MAY (M D)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MAY
Last Name:HOSTETLER
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 MISSION RD
Mailing Address - Street 2:#350
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3006
Mailing Address - Country:US
Mailing Address - Phone:913-642-2100
Mailing Address - Fax:913-642-2127
Practice Address - Street 1:7301 MISSION RD
Practice Address - Street 2:#350
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3006
Practice Address - Country:US
Practice Address - Phone:913-642-2100
Practice Address - Fax:913-642-2127
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430263208000000X
MO2003010766208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics