Provider Demographics
NPI:1376992925
Name:FRUTCHEY, AMIEE MORGAN (PA)
Entity Type:Individual
Prefix:
First Name:AMIEE
Middle Name:MORGAN
Last Name:FRUTCHEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2727 PACES FERRY RD SE STE 1-1100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6151
Mailing Address - Country:US
Mailing Address - Phone:404-605-2050
Mailing Address - Fax:404-335-8421
Practice Address - Street 1:2001 PEACHTREE RD NE STE 645
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-605-2050
Practice Address - Fax:404-335-8421
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant