Individual
AMANDA LYNN WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
233 LONGTOWN RD, COLUMBIA, SC 29229-8550
(803) 865-2122
Mailing address
324 AVENSONG TRL, ELGIN, SC 29045-7141
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
APN.29187
SC
363LF0000X
Family Nurse Practitioner
Primary
APN.29187
SC
363LP2300X
Primary Care Nurse Practitioner
APN.29187
SC
Other
Enumeration date
05/31/2024
Last updated
08/03/2026
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