Provider Demographics
NPI:1619565421
Name:BECKNER, AMANDA MARIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARIE
Last Name:BECKNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 KINGSTON CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-9347
Mailing Address - Country:US
Mailing Address - Phone:661-343-7842
Mailing Address - Fax:
Practice Address - Street 1:25 CHATHAM CTR S STE 200
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1302
Practice Address - Country:US
Practice Address - Phone:912-912-1148
Practice Address - Fax:912-436-0844
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN249383363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily