Individual ProviderAmanda Kaye NosbushPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address7840 Vinewood Ln N, Maple Grove, MN 55369-7185(763) 236-0200PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Kaye Nosbush does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1336792647Provider TypeIndividualFull NameNosbush, Amanda KayeGenderFemaleSole ProprietorNoEnumeration Date7/17/2019Last Updated7/17/2019Contact InformationPractice LocationPractice Address7840 Vinewood Ln N, Maple Grove, MN 55369-7185Phone(763) 236-0200FaxUnlisted FaxMailing LocationMailing Address68849 Fort Rd, Fairfax, MN 55332-6935PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense11477Minnesota