Individual
MRS. AMANDA JO CORDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP, FNP-C
Contact information
Practice address
4245 BALMORAL DR SW STE 102, HUNTSVILLE, AL 35801-6456
(256) 882-6555
Mailing address
4245 BALMORAL DR SW STE 102, HUNTSVILLE, AL 35801-6456
(256) 882-6555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-147493
AL
363LF0000X
Family Nurse Practitioner
24205
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-147493
DIRECT PRIMARY CARE CLINIC
AL
Enumeration date
04/24/2018
Last updated
02/05/2019
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