IndividualActive
Amanda Diercks, N.P.
NPI 1679946156 · Nurse Practitioner · Saint Louis, MO
Provider details
- NPI number
- 1679946156
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- N.P.
- Sex
- Female
- Sole proprietor
- No
- License
- 2015039589 (MO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
5347 Glencullen Way
Saint Louis, MO 63128-4229
Phone: (314) 488-4289
Approximate (ZIP-level) locationGet directions
Mailing address
5347 Glencullen Way
Saint Louis, MO 63128-4229
Registry dates
- Enumerated
- 2015-11-05
- Last updated
- 2015-11-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.