Provider Demographics
NPI:1366673014
Name:MCVAY, AMANDA (CNM)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MCVAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-6601
Mailing Address - Country:US
Mailing Address - Phone:229-888-3636
Mailing Address - Fax:229-888-5535
Practice Address - Street 1:401 S MADISON ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-6601
Practice Address - Country:US
Practice Address - Phone:229-888-3636
Practice Address - Fax:229-888-5535
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN184986363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology