Mrs Amanda Sue Al-khudairi, MSN, RNC, APRN in Salt Lake City, UT

Mrs Amanda Sue Al-khudairi, MSN, RNC, APRN is a medicare enrolled "Nurse Practitioner - Women's Health" in Salt Lake City, Utah. Her current practice location is 1906 W 3600 S, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 973-9675.

Mrs Amanda Sue Al-khudairi is licensed to practice in Utah (license number 372242-4405) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1861613242.

Contact Information

	Mrs Amanda Sue Al-khudairi, MSN, RNC, APRN
	1906 W 3600 S, Salt Lake City, UT 84119-4715
	(801) 973-9675
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Amanda Sue Al-khudairi
Gender	Female
Speciality	Nurse Practitioner - Women's Health
Location	1906 W 3600 S, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861613242
Provider Enumeration Date: 05/01/2007
Last Update Date: 10/16/2021

Medicare PECOS Information:

PECOS PAC ID: 1658457676
Enrollment ID: I20080331000338

Medical Identifiers

Medical identifiers for Mrs Amanda Sue Al-khudairi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861613242	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LW0102X	Nurse Practitioner - Women's Health	372242-4405 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Amanda Sue Al-khudairi allows following entities to bill medicare on her behalf.

Entity Name	University Of Utah Adult Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Amanda Sue Al-khudairi is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Amanda Sue Al-khudairi, MSN, RNC, APRN 6900 S 800 E, Midvale, UT 84047-1431 Ph: (801) 569-9363	Mrs Amanda Sue Al-khudairi, MSN, RNC, APRN 1906 W 3600 S, Salt Lake City, UT 84119-4715 Ph: (801) 973-9675

Reviews and Comments

Nurse Practitioner Nurses in Salt Lake City, UT

Mrs. Lisa Ann Runyon, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Trauma Services, Salt Lake City, UT 84113 Phone: 801-662-2993 Fax: 801-662-2999
Madeline Ann Thayer, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-3600
Emma Fong, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3802 S 700 E, Salt Lake City, UT 84106 Phone: 801-264-6000
Ashlee Brynn Fenton, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1160 E 3900 S Ste G200, Salt Lake City, UT 84124 Phone: 801-268-7766
Donna M. Wahoff-stice, APRN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 615 Arapeen Dr, 100, Salt Lake City, UT 84108 Phone: 801-581-7761
Linda M Lambert, A.P.R.N. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Salt Lake City, UT 84113 Phone: 801-662-1000
Ms. Ann A. K. Kamp, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 Fax: 801-662-4166

Mrs Amanda Sue Al-khudairi, MSN, RNC, APRN - Medicare Nurse Practitioner in Salt Lake City, UT