Provider Demographics
NPI:1447061791
Name:SUING, AMANDA LEE
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:SUING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:LEE
Other - Last Name:SUING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4905 S 192ND AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-2104
Mailing Address - Country:US
Mailing Address - Phone:712-898-6511
Mailing Address - Fax:
Practice Address - Street 1:4905 S 192ND AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-2104
Practice Address - Country:US
Practice Address - Phone:712-898-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child