Provider Demographics
NPI:1811733173
Name:CARNEY, AMANDA KELLY
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KELLY
Last Name:CARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 BENNETT POINT RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21658-1105
Mailing Address - Country:US
Mailing Address - Phone:410-868-7370
Mailing Address - Fax:
Practice Address - Street 1:2405 YORK RD STE 201
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2252
Practice Address - Country:US
Practice Address - Phone:410-868-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach