Amanda Boudreaux, R.N.
Individual provider Active NPI Registered Nurse · Kingsport, TN
NPI 1376949586 · NPPES record last updated Nov 16, 2014
Key facts
- NPI
- 1376949586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 201347 (TN)
- Practice address
- 320 Akers Ave
Kingsport, TN 37665-1934 - Phone
- (972) 890-7839
- NPI assigned
- Nov 16, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201347 | TN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201347 | TN | Yes |
Addresses
Primary practice location
320 Akers Ave
Kingsport, TN 37665-1934
Mailing address
320 Akers Ave
Kingsport, TN 37665-1934
Phone (972) 890-7839
Other names
- Amanda Morgan
Other providers in Kingsport, TN
- Johnnie Bonner
- James Michael Bookout
- Benjamin Borders
- James Hunter Botts
- Devi Prasad Botu
- Renee L Boulicault
- Melanie Creppel Bourgeois
- Vickie R Bowen
- Carissa Renee Bowery
- Jacqlyne Weber Bowman
All providers in Kingsport, TN · Registered Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.