Provider Demographics
NPI:1962630327
Name:GASTRIGHT, AMANDA LEIGH (ARNP, NP-C, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LEIGH
Last Name:GASTRIGHT
Suffix:
Gender:F
Credentials:ARNP, NP-C, FNP-BC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LEIGH
Other - Last Name:DOAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-341-3114
Mailing Address - Fax:859-578-2156
Practice Address - Street 1:300 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-2107
Practice Address - Country:US
Practice Address - Phone:859-635-9440
Practice Address - Fax:859-448-2622
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.350273363L00000X
IN71002860A363L00000X
KY3006025363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
352199392 1770565954OtherHEALTHNET
IN200956080Medicaid
OH3003878Medicaid
000000622329OtherANTHEM
KY7100080190Medicaid
$$$$$$$$$00OtherOHIO BWC
GANP31501Medicare PIN
KY7100080190Medicaid
$$$$$$$$$00OtherOHIO BWC