Provider Demographics
NPI:1215374020
Name:MEISEL, AMANDA WARD (CNM)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:WARD
Last Name:MEISEL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:WARD
Other - Last Name:SHACKELFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7535 CARPENTER FIRE STATION ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8617
Mailing Address - Country:US
Mailing Address - Phone:919-230-2100
Mailing Address - Fax:919-230-2133
Practice Address - Street 1:781 AVENT FERRY RD STE 106
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-567-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC523367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife