Provider Demographics
NPI:1447515267
Name:HOMAN, AMY MARIE (CNP)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:HOMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9321 W THOMAS RD STE 420
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3399
Mailing Address - Country:US
Mailing Address - Phone:855-776-7266
Mailing Address - Fax:602-336-7698
Practice Address - Street 1:6601 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-5700
Practice Address - Country:US
Practice Address - Phone:602-243-7277
Practice Address - Fax:623-247-9742
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHNP13429363LF0000X
AZAP8760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily