Provider Demographics
NPI:1205999844
Name:EDWARDS, AMANDA J (AUD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:615-936-5088
Practice Address - Street 1:1215 21ST AVE S
Practice Address - Street 2:SUITE 9302
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-8025
Practice Address - Country:US
Practice Address - Phone:615-322-4327
Practice Address - Fax:615-936-5088
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1681231H00000X
TN1395231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
613258400OtherOWCP-DOL FECA AND DEEOIC
TN9068084OtherAETNA
TN4165989OtherBCBS OF TN
KY7100033990Medicaid
TN01161027OtherAMERIGROUP TENNCARE
10028887OtherSIGNATURE HEALTH PLANS
TN39671221Medicaid
5687960OtherCIGNA
TN39671221Medicaid