Provider Demographics
NPI:1881022788
Name:PASCHALL, AMANDA HAYNES (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:HAYNES
Last Name:PASCHALL
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 1:1125 ALSTON VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1852
Mailing Address - Country:US
Mailing Address - Phone:252-916-1382
Mailing Address - Fax:
Practice Address - Street 1:876 TIMBER DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4850
Practice Address - Country:US
Practice Address - Phone:919-803-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006565363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily