| Doctor Name: | AMANDA KIMBERLY OMALLEY |
| NPI Number: | 1073936761 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AG-ANCP |
| License Number: | 4704268714 |
| Business Practice Address: | 9626 S Congress St New Market, VA - 228449450 |
| Business Phone Number: | 5407403044 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1430, HARRISONBURG |
| State: | VA |
| Postal Code: | 228031430 |
| Phone Number: | 5405647036 |
| Fax Number: | 5405647172 |
| NPI Enumeration Date: | 01/30/2014 |
| NPI Last Update Date: | 11/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 4704268714 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |