Provider Demographics
NPI:1205617651
Name:LEONARD, AMANDA MURPHY (APRN)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MURPHY
Last Name:LEONARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:SC
Mailing Address - Zip Code:29388-9198
Mailing Address - Country:US
Mailing Address - Phone:305-778-3456
Mailing Address - Fax:
Practice Address - Street 1:1667 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-9217
Practice Address - Country:US
Practice Address - Phone:864-485-2610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily