Provider Demographics
NPI:1780041186
Name:DODD, AMANDA N (FNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:N
Last Name:DODD
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 1:1111 WAYNE RD NW
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-3567
Mailing Address - Country:US
Mailing Address - Phone:256-288-3333
Mailing Address - Fax:256-288-3334
Practice Address - Street 1:201 AVALON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2805
Practice Address - Country:US
Practice Address - Phone:256-386-1600
Practice Address - Fax:256-386-1303
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-127047363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner