Individual
AMANDA R BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-7050
(864) 560-0800
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN2621
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000568
—
NC
01
—
AA12673365
MEDICARE PIN
SC
05
—
NP1408
—
SC
Enumeration date
12/22/2005
Last updated
04/27/2022
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