Individual
MS. AMANDA BAIRD STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15195 HEATHCOTE BLVD, HAYMARKET, VA 20169-6242
(571) 261-3529
(703) 361-1811
Mailing address
PO BOX 748613, ATLANTA, GA 30384-8613
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024176366
NC
363L00000X
Nurse Practitioner
Primary
0024176366
VA
Other
Enumeration date
04/14/2018
Last updated
02/24/2023
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