Provider Demographics
NPI:1669043923
Name:CUTSHAW, AMANDA DORSEY (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:DORSEY
Last Name:CUTSHAW
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 RIGHT PRONG RD
Mailing Address - Street 2:
Mailing Address - City:ELLENBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28040-4737
Mailing Address - Country:US
Mailing Address - Phone:828-289-3041
Mailing Address - Fax:
Practice Address - Street 1:212 ALLENDALE DR
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-2889
Practice Address - Country:US
Practice Address - Phone:828-245-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC217648163W00000X
NC5014716363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse