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Individual

AMANDA WALL BLAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP-BC

Contact information

Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(800) 243-3839
Mailing address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
RN197245
GA
363LN0000X
Neonatal Nurse Practitioner
Primary
RN197245
GA

Other

Enumeration date
12/15/2021
Last updated
03/20/2025
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