Individual
AMANDA R. WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-AA
Contact information
Practice address
1255 HIGHWAY 54 WEST, FAYETTEVILLE, GA 30214-4548
(404) 351-1745
(404) 351-7121
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
006561
GA
367H00000X
Anesthesiologist Assistant
TL20
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AA0016
—
SC
01
—
P00897043
RAILROAD MEDICARE
SC
Enumeration date
09/24/2010
Last updated
02/26/2016
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