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Amanda Sissom
NPI 1407374887 · on the registry since 2017
Practice
- Address
- 1905 S Topaz Way Ste 100
Meridian, ID 83642 - Phone
- (208) 417-7971
- Clinicians at this address
- 78
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 222Q00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-01-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho