Provider Demographics
NPI:1891773990
Name:SANCHEZ, AMANDA H (APRN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:H
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:HANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-695-6071
Mailing Address - Fax:843-569-5879
Practice Address - Street 1:809 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6605
Practice Address - Country:US
Practice Address - Phone:843-871-9440
Practice Address - Fax:843-871-5932
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2858OtherMEDICAID GROUP
SCNP0985Medicaid
SCP00914052OtherRR MEDICARE
SCQ63726Medicare UPIN
SCNP0985Medicaid
SCGP2858OtherMEDICAID GROUP