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Individual

MRS. AMANDA KNAUER HALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
114 SUTHERLIN DR STE 1C, WARNER ROBINS, GA 31088-2259
(478) 287-6144
Mailing address
114 SUTHERLIN DR STE 1C, WARNER ROBINS, GA 31088-2259
(478) 287-6144

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5964
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003126689A
GA
05
003126689B
GA
Enumeration date
12/08/2010
Last updated
11/17/2015
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