Individual
AMANDA MORDECAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2520 5TH ST N, COLUMBUS, MS 39705-2008
(662) 244-2966
(662) 244-2763
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901639
MS
Other
Enumeration date
07/08/2016
Last updated
03/04/2020
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