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Individual

AMANDA FORTNER MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1303 GAULT AVE N STE IV, FORT PAYNE, AL 35967-3104
(256) 273-5320
(256) 273-5320
Mailing address
1303 GAULT AVE N STE IV, FORT PAYNE, AL 35967-3104
(256) 273-5320
(256) 273-5320

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1328
AL
363A00000X
Physician Assistant
AL
363AS0400X
Surgical Physician Assistant
Primary
PA1328
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
220540
AL
Enumeration date
01/26/2018
Last updated
01/29/2026
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