Individual
MRS. AMANDA BAYNARD RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
3001 LAKE BROOK BLVD STE 101, KNOXVILLE, TN 37909-3761
(865) 374-0500
Mailing address
3001 LAKE BROOK BLVD STE 101, KNOXVILLE, TN 37909-3761
(865) 374-0500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
24269
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP7155
—
SC
05
—
Q080166
—
TN
01
—
SCI9047628
MEDICARE PIN
SC
Enumeration date
08/16/2020
Last updated
12/12/2024
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