Individual
AMANDA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2959 SHARPSBURG MCCULLUM RD, NEWNAN, GA 30265-2297
(770) 502-2020
(770) 502-2029
Mailing address
2959 SHARPSBURG MCCULLUM RD, NEWNAN, GA 30265-2297
(770) 502-2020
(770) 502-2029
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN145030
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
987163439A
—
GA
Enumeration date
10/11/2006
Last updated
12/07/2011
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