Provider Demographics
NPI:1235509100
Name:PARRISH, AMANDA (RNC-MNN, IBCLC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:RNC-MNN, IBCLC
Other - Prefix:
Other - First Name:MANDI
Other - Middle Name:
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNC-MNN, IBCLC
Mailing Address - Street 1:4530 SETTLES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1982
Mailing Address - Country:US
Mailing Address - Phone:404-996-8648
Mailing Address - Fax:844-636-0985
Practice Address - Street 1:4530 SETTLES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1982
Practice Address - Country:US
Practice Address - Phone:404-996-8648
Practice Address - Fax:844-636-0985
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-04
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA228233163W00000X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse