Provider Demographics
NPI:1497872733
Name:PERRY, AMANDA (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W CLINCH AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-2203
Mailing Address - Country:US
Mailing Address - Phone:865-525-0228
Mailing Address - Fax:865-525-0285
Practice Address - Street 1:2201 W CLINCH AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2203
Practice Address - Country:US
Practice Address - Phone:865-525-0228
Practice Address - Fax:865-525-0285
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8447363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN8447OtherLICENSE