Provider Demographics
NPI:1023814712
Name:KOM, AMANDA CHRISTINA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHRISTINA
Last Name:KOM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CHRISTINA
Other - Last Name:MURAWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:4097 SPYGLASS HL
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3304
Mailing Address - Country:US
Mailing Address - Phone:513-310-5346
Mailing Address - Fax:
Practice Address - Street 1:4097 SPYGLASS HL
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3304
Practice Address - Country:US
Practice Address - Phone:513-310-5346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH424087163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health