Individual
AMANDA CARPENTER CLOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CPNP-PC
Contact information
Practice address
301 MEDICAL DR STE 504, LAGRANGE, GA 30240-4172
(404) 518-7817
Mailing address
450 GORDON CIR, LAGRANGE, GA 30240-2644
(404) 518-7817
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN220550
GA
Other
Enumeration date
06/15/2017
Last updated
06/15/2017
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