Individual
AMANDA MICHELLE LAUDERBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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