Individual
AMANDA MICHELLE LAUDERBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
115 EAGLE SPRING DR, STOCKBRIDGE, GA 30281-6486
(770) 474-0064
(770) 474-2998
Mailing address
115 EAGLE SPRING DR, STOCKBRIDGE, GA 30281-6486
(770) 474-0064
(770) 474-2998
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN186980
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003131811A
MEDICAID
GA
01
—
RN186980
MEDICAL LICENSE
GA
Enumeration date
01/22/2013
Last updated
10/15/2025
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