Individual
AMANDA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6025 WALNUT GROVE RD, SUITE 111, MEMPHIS, TN 38120-2131
(901) 226-2000
(901) 271-4187
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
19977
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q024138
—
TN
Enumeration date
04/27/2015
Last updated
11/05/2019
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