Provider Demographics
NPI:1417430208
Name:GOTTSCHANG, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GOTTSCHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 WINDHURST DR SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2491
Mailing Address - Country:US
Mailing Address - Phone:678-362-5061
Mailing Address - Fax:
Practice Address - Street 1:3741 WINDHURST DR SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2491
Practice Address - Country:US
Practice Address - Phone:770-979-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2018-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula