Provider Demographics
NPI:1548585219
Name:HADDAD, AMANDA JANE (MSN, CNM, WHNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:JANE
Last Name:HADDAD
Suffix:
Gender:F
Credentials:MSN, CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1692 CHATHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-1350
Mailing Address - Country:US
Mailing Address - Phone:912-629-6262
Mailing Address - Fax:
Practice Address - Street 1:1692 CHATHAM PKWY
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1350
Practice Address - Country:US
Practice Address - Phone:912-629-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN234946367A00000X
SC21656367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife