Individual
AMANDA GAYLE PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3620 HARRIS RD, WAYCROSS, GA 31503-0311
(912) 287-4856
Mailing address
156 ELIZABETH ST, FOLKSTON, GA 31537-2926
(912) 390-9537
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN222648
GA
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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