| Doctor Name: | AMANDA PASSINT |
| NPI Number: | 1275948077 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 20082701 |
| Business Practice Address: | 411 Pewaukee Rd Pewaukee, WI - 530725886 |
| Business Phone Number: | 2626955145 |
| Business Fax Number: | |
| Mailing Address: | W224n2824 Stonewood Ct, WAUKESHA |
| State: | WI |
| Postal Code: | 531861042 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/01/2014 |
| NPI Last Update Date: | 07/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 20082701 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |