| Doctor Name: | MRS. AMANDA LEE TAGLIOLI |
| NPI Number: | 1073794269 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 0513 |
| Business Practice Address: | 1041 Montgomery Street Custer, SD - 577301304 |
| Business Phone Number: | 6056734150 |
| Business Fax Number: | 6056733917 |
| Mailing Address: | 317 Apple Dr, STEAMBOAT SPRINGS |
| State: | CO |
| Postal Code: | 804873074 |
| Phone Number: | 9704616140 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2007 |
| NPI Last Update Date: | 09/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0513 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |