Individual
AMANDA MICHELLE OUTLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
61 WHITCHER ST NE STE 3110, MARIETTA, GA 30060-1179
(770) 422-2326
(770) 422-7231
Mailing address
61 WHITCHER ST NE STE 3110, MARIETTA, GA 30060-1179
(770) 422-2326
(770) 422-7231
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13002
GA
363A00000X
Physician Assistant
PA9110768
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022418500
—
FL
01
—
N3KG2
BCBSFL
FL
Enumeration date
06/26/2015
Last updated
04/07/2026
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