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Individual

AMANDA LYNN MAYNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
428 E MAIN ST, INEZ, KY 41224-8931
(606) 298-2660
Mailing address
PO BOX 1269, INEZ, KY 41224-1269
(606) 534-7500

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007639
KY
363LF0000X
Family Nurse Practitioner
63087
WV

Other

Enumeration date
10/08/2012
Last updated
10/08/2012
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