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Individual

AMANDA RENEE JEWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
22 E CHURCH ST STE 308, MARTINSVILLE, VA 24112-6208
(276) 618-1125
Mailing address
410 LEES RIDGE RD, MARTINSVILLE, VA 24112-0512
(716) 940-5280

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0024184204
VA
251S00000X
Community/Behavioral Health Agency
0024184204
VA

Other

Enumeration date
12/14/2015
Last updated
11/08/2023
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