Provider Demographics
NPI:1689445678
Name:WILLIAMS, AMANDA MUSICK (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MUSICK
Last Name:WILLIAMS
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 1:222 GORDON STEET
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110
Mailing Address - Country:US
Mailing Address - Phone:770-634-8905
Mailing Address - Fax:
Practice Address - Street 1:222 GORDON STEET
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110
Practice Address - Country:US
Practice Address - Phone:770-634-8905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN236272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily