Provider Demographics
NPI:1457957946
Name:GRAB, AMANDA LYN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYN
Last Name:GRAB
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 CITY CENTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3080
Mailing Address - Country:US
Mailing Address - Phone:757-599-4090
Mailing Address - Fax:
Practice Address - Street 1:895 CITY CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3080
Practice Address - Country:US
Practice Address - Phone:757-599-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily