Individual
AMANDA M HEDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M MSN CPN
Contact information
Practice address
2423 WILLIAMS DR STE 103, GEORGETOWN, TX 78628-3200
(877) 800-5722
(512) 930-7400
Mailing address
205 E UNIVERSITY AVE STE 200, GEORGETOWN, TX 78626-6821
(512) 868-1124
(512) 868-9894
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP112440
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134280-01
—
TX
01
—
640141
STATE BOARD OF NURSING LICNESEREGISTERED NURSE
TX
01
—
AP112440
STATE BOARD OF NURSING LICENSEPEDIATRIC NURSE PRACTITIONER
TX
Enumeration date
12/02/2009
Last updated
05/20/2022
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