Amburn, Mandi Glynn

Amburn, Mandi Glynn is an individual health care provider with primary practice located at 2200 Park Bend Dr Building 1 Suite 301, Austin TX 78758-5387. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Amburn, Mandi Glynn can be contacted via phone (512) 339-0440.

Contact Information

Primary practice address
2200 Park Bend Dr Building 1 Suite 301 Austin TX 78758-5387
Phone: (512) 339-0440
Fax: (512) 339-0454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10227 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA04670 Texas

Profile Details

NPI number 1780787986
LBN Legal business name Amburn, Mandi Glynn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Jan 26th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780787986 NPPES
Minnesota Other P00408065 RAILROAD MEDICARE
Minnesota Other 8N9216 RAILROAD MEDICARE
Minnesota MEDICAID 517690000 RAILROAD MEDICARE

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