Provider Demographics
NPI:1831066406
Name:EDWARDS, AMANDA CAREY (RN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAREY
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2428 KNOB CREEK RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2397
Mailing Address - Country:US
Mailing Address - Phone:423-390-6335
Mailing Address - Fax:423-297-4759
Practice Address - Street 1:2428 KNOB CREEK RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2397
Practice Address - Country:US
Practice Address - Phone:423-390-6335
Practice Address - Fax:423-297-4759
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN40174363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner