Provider Demographics
NPI:1841012879
Name:PROFFITT, AMARA (NP)
Entity type:Individual
Prefix:
First Name:AMARA
Middle Name:
Last Name:PROFFITT
Suffix:
Gender:
Credentials:NP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:353 NEW SHACKLE ISLAND RD STE 148C
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2366
Mailing Address - Country:US
Mailing Address - Phone:615-972-1100
Mailing Address - Fax:615-537-4950
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD STE 148C
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2366
Practice Address - Country:US
Practice Address - Phone:615-972-1100
Practice Address - Fax:615-537-4950
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN37256363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner