Provider Demographics
NPI:1134618317
Name:DENSON, AMANDA BURNS (FNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BURNS
Last Name:DENSON
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 1:1181 LANGFORD DRIVE
Mailing Address - Street 2:BLDG 300, SUITE 104
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7322
Mailing Address - Country:US
Mailing Address - Phone:706-850-3444
Mailing Address - Fax:706-850-3448
Practice Address - Street 1:1181 LANGFORD DRIVE
Practice Address - Street 2:BUILDING 300, SUITE 104
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677
Practice Address - Country:US
Practice Address - Phone:706-850-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN261483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily