Provider Demographics
NPI:1659801538
Name:GRIER, AMANDA BROOKE (MSN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BROOKE
Last Name:GRIER
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:BROOKE
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2330 ANTIOCH RD
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-6247
Mailing Address - Country:US
Mailing Address - Phone:334-328-9018
Mailing Address - Fax:
Practice Address - Street 1:2105 E SOUTH BLVD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116
Practice Address - Country:US
Practice Address - Phone:334-288-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131469163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse