Individual
MRS. AMANDA L WILTSHIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
401 SOUTHCREST CIR STE 212, SOUTHAVEN, MS 38671-6721
(662) 245-5270
(662) 351-9471
Mailing address
401 SOUTHCREST CIR STE 212, SOUTHAVEN, MS 38671-6721
(662) 245-5270
(662) 351-9471
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
903415
MS
363L00000X
Nurse Practitioner
Primary
903415
MS
363LA2200X
Adult Health Nurse Practitioner
903415
MS
363LG0600X
Gerontology Nurse Practitioner
903415
MS
363LP2300X
Primary Care Nurse Practitioner
903415
MS
Other
Enumeration date
07/05/2019
Last updated
06/13/2024
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