Provider Demographics
NPI:1275726754
Name:FORBUS, AMANDA WASHBURN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:WASHBURN
Last Name:FORBUS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CHRISTINE
Other - Last Name:WASHBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 RUTLEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5821
Mailing Address - Country:US
Mailing Address - Phone:843-792-6906
Mailing Address - Fax:843-792-1729
Practice Address - Street 1:181 CALHOUN ST.
Practice Address - Street 2:COLLEGE OF CHARLESTON STUDENT HEATLH
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424
Practice Address - Country:US
Practice Address - Phone:843-953-5520
Practice Address - Fax:843-792-1729
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3140363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily