Provider Demographics
NPI:1851476154
Name:HAMBY, AMANDA D (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:D
Last Name:HAMBY
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HAIRETOWN RD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-4619
Mailing Address - Country:US
Mailing Address - Phone:423-753-0715
Mailing Address - Fax:
Practice Address - Street 1:208 SUNCREST ST
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-3494
Practice Address - Country:US
Practice Address - Phone:423-477-3847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN250100103031389183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician