Provider Demographics
NPI:1902447477
Name:DYKES, AMANDA KAY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAY
Last Name:DYKES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:KAY
Other - Last Name:DYKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMANDA KAY STERKEL
Mailing Address - Street 1:623 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-2739
Mailing Address - Country:US
Mailing Address - Phone:307-338-0273
Mailing Address - Fax:
Practice Address - Street 1:111 S 5TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633
Practice Address - Country:US
Practice Address - Phone:307-358-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY44725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily