Provider Demographics
NPI:1578990016
Name:MORRIS, AMANDA NESS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:NESS
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:NESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1835 SAVOY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1072
Mailing Address - Country:US
Mailing Address - Phone:770-590-8311
Mailing Address - Fax:770-590-8313
Practice Address - Street 1:790 CHURCH ST NE STE 335
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8957
Practice Address - Country:US
Practice Address - Phone:770-590-8311
Practice Address - Fax:770-590-8313
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006995363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003139387FMedicaid
GA003139387EMedicaid
GA202I973702OtherMEDICARE