Provider Demographics
NPI:1043726557
Name:JAMES, AMANDA GAMMEL (PCPNP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:GAMMEL
Last Name:JAMES
Suffix:
Gender:F
Credentials:PCPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 197
Mailing Address - Street 2:
Mailing Address - City:DEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71328-0197
Mailing Address - Country:US
Mailing Address - Phone:318-229-3399
Mailing Address - Fax:
Practice Address - Street 1:431 W LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-3463
Practice Address - Country:US
Practice Address - Phone:318-648-0375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA363LP0200X208000000X
LAAP09531363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics