Amanda Quinn, FNP

Individual provider Active NPI Family Nurse Practitioner · Tunnel Hill, GA

NPI 1306228887 · NPPES record last updated Jun 22, 2015

Key facts

NPI
1306228887
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN240724 (GA)
Practice address
134 Rhea McClanahan Dr
Tunnel Hill, GA 30755-7328
Phone
(706) 516-1814
Fax
(706) 965-5941
NPI assigned
Jun 22, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151020001878 GA Order and Referring Only - Nurse Practitioner 2163731852

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN240724 GA Yes

Addresses

Primary practice location

134 Rhea McClanahan Dr
Tunnel Hill, GA 30755-7328

Mailing address

13570 N Main St
Trenton, GA 30752-2012
Phone (706) 956-2665

Other identifiers

IdentifierTypeStateIssuer
000211956CMedicaidGA
003138289AMedicaidGA
000211956AMedicaidGA

Other providers in Tunnel Hill, GA

All providers in Tunnel Hill, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.