| Amanda Nicole Polanco, FNP | |
|
16850 Bear Valley Rd, Victorville, CA 92395-5794 | |
| (760) 241-8000 | |
| Not Available |
| Full Name | Amanda Nicole Polanco |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 16850 Bear Valley Rd, Victorville, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235902735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 95024607 (California) | Primary |
| Entity Name | Desert Valley Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639117864 PECOS PAC ID: 4880595875 Enrollment ID: O20040113000803 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Nicole Polanco, FNP 16850 Bear Valley Rd, Victorville, CA 92395-5794 Ph: (760) 241-8000 | Amanda Nicole Polanco, FNP 16850 Bear Valley Rd, Victorville, CA 92395-5794 Ph: (760) 241-8000 |
Bukola Gross, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13010 Hesperia Rd Ste 501, Victorville, CA 92395 Phone: 760-881-3717 | |
Jessica C Smith, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16850 Bear Valley Rd, Victorville, CA 92395 Phone: 760-241-8000 Fax: 760-241-0393 | |
Mrs. Shawntel Logan, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12760 Hesperia Rd Ste C, Victorville, CA 92395 Phone: 760-338-0911 | |
Krystle Ann Frazier, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16850 Bear Valley Rd, Victorville, CA 92395 Phone: 760-241-8000 | |
Noarie Iverie Magoun, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12677 Hesperia Rd Ste 130, Victorville, CA 92395 Phone: 760-241-7763 Fax: 760-241-6383 | |
Jose Manuel Ortega, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16850 Bear Valley Rd, Victorville, CA 92395 Phone: 760-241-8000 | |
Cindy Alvarez, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11857 Elliot Way, Victorville, CA 92392 Phone: 818-400-5438 |