Provider Demographics
NPI:1265903421
Name:VOLKER, AMANDA NASEEF (NP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:NASEEF
Last Name:VOLKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:NASEEF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1796 BRITTANY CHASE NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-6902
Mailing Address - Country:US
Mailing Address - Phone:513-919-7284
Mailing Address - Fax:
Practice Address - Street 1:12195 HIGHWAY 92 STE 144
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3603
Practice Address - Country:US
Practice Address - Phone:678-540-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN227490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily