Provider Demographics
NPI:1740553429
Name:MOUNCE, AMANDA ALLEN (FNP)
Entity type:Individual
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First Name:AMANDA
Middle Name:ALLEN
Last Name:MOUNCE
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Gender:F
Credentials:FNP
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7008
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:861 OLD WINSTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7140
Practice Address - Country:US
Practice Address - Phone:336-802-2300
Practice Address - Fax:336-802-2301
Is Sole Proprietor?:No
Enumeration Date:2012-02-11
Last Update Date:2014-01-13
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Provider Licenses
StateLicense IDTaxonomies
NC219532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1740553429Medicaid