Amanda Lyle Tullidge, AGACNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024184922 Issued in VA

Practice address

223 Wadsworth Dr
North Chesterfield, VA 23236-4510

Phone

(804) 330-4021

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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  Nurse Practitioner

  NPD (past)
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  • NPI 1831715929
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1609595842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 WADSWORTH DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 WADSWORTH DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364510",
            "telephone_number": "804-330-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLIDGE",
        "first_name": "AMANDA",
        "middle_name": "LYLE",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024184922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Truong
• Trusting Hands Mental Health Community Services LLC
• Trusting-Hands Mental Health Services
• Alyssa Lynn Tsui, OTD, OTR/L
• Corinne Nancy Tuckey-Larus, MD
• April Turner, LMT
• Glenda Turner, CPM
• Jessica Turner
• Merissa June Lantz Turner, NP
• Daniell Twyman

• Nurse Practitioner in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.