Whiteside, Amanda Rae

Whiteside, Amanda Rae is an sole proprietor health care provider with primary practice located at 14520 W Granite Valley Dr Ste 210 , Sun City West AZ 85375-5855. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Whiteside, Amanda Rae can be contacted via phone (866) 974-2673.

Contact Information

Primary practice address
14520 W Granite Valley Dr Ste 210 Sun City West AZ 85375-5855
Phone: (866) 974-2673
Fax: (866) 939-2673
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 7530 Arizona
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 7530 Arizona

Profile Details

NPI number 1396210621
LBN Legal business name Whiteside, Amanda Rae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2018
Last updated Aug 11th, 2025 - about last year

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 1396210621 NPPES
Arizona MEDICAID 583027

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