Provider Demographics
NPI:1053414904
Name:CERVANTES, AMANDA J (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:J
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 E GOLD COAST RD.
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-5811
Mailing Address - Country:US
Mailing Address - Phone:402-597-9378
Mailing Address - Fax:402-597-9253
Practice Address - Street 1:1401 E GOLD COAST RD.
Practice Address - Street 2:SUITE 600
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-5811
Practice Address - Country:US
Practice Address - Phone:402-597-9378
Practice Address - Fax:402-597-9253
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE195452084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry