Individual
AMANDA LYNN NOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
72 PHYSICIANS DR, JACKSON, TN 38305-2070
(731) 660-6395
Mailing address
37 WIND TREE CV, JACKSON, TN 38305-2974
(570) 903-4683
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
1697
AL
363A00000X
Physician Assistant
1697
AL
363A00000X
Physician Assistant
Primary
5112
TN
Other
Enumeration date
12/01/2020
Last updated
02/17/2026
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