Provider Demographics
NPI:1366831935
Name:GUETTLER, AMANDA (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:GUETTLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:GOODSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:820 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-1822
Mailing Address - Country:US
Mailing Address - Phone:334-688-7410
Mailing Address - Fax:
Practice Address - Street 1:825 W WASHINGTON ST STE 7
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1851
Practice Address - Country:US
Practice Address - Phone:334-688-7410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-120210163WC1500X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health