# JODY L AMAZON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1427038470
- **Gender:** F
- **Credential:** N.P.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | R096082 | GA | Yes |

## Other

- **Enumeration date:** 01/18/2006
- **Last updated:** 01/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000771196C | — | GA |
| 01 | — | 50BBKVV | MEDICARE PROVIDER NUMBER | GA |