Provider Demographics
NPI:1992479489
Name:DEWEES, AMANDA (CNA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:DEWEES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 W OAK AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ULLIN
Mailing Address - State:ND
Mailing Address - Zip Code:58631-7321
Mailing Address - Country:US
Mailing Address - Phone:701-329-9870
Mailing Address - Fax:
Practice Address - Street 1:200 S 6TH ST
Practice Address - Street 2:
Practice Address - City:GLEN ULLIN
Practice Address - State:ND
Practice Address - Zip Code:58631-7361
Practice Address - Country:US
Practice Address - Phone:701-329-9870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant