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Individual
AMANDA MICHELLE WAITE
Active
Individual
AMANDA MICHELLE WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
19896
SC
363LA2100X
Acute Care Nurse Practitioner
19896
SC
363LA2100X
Acute Care Nurse Practitioner
R210436
MD
Other
Enumeration date
04/29/2014
Last updated
10/26/2023
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