Provider Demographics
NPI:1992317507
Name:WARNER, AMANDA AULD (FNP - BC)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:AULD
Last Name:WARNER
Suffix:
Gender:
Credentials:FNP - BC
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:AULD
Other - Last Name:ALDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1400 VALLEY RIVER DR STE 220
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6759
Mailing Address - Country:US
Mailing Address - Phone:541-435-2227
Mailing Address - Fax:866-531-8013
Practice Address - Street 1:1400 VALLEY RIVER DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6758
Practice Address - Country:US
Practice Address - Phone:541-435-2227
Practice Address - Fax:866-531-8013
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201900132NP-PP363L00000X
OR201911320NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner