Individual
MRS. AMANDA S MOORHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
202 W FAIRVIEW AVE, JOHNSON CITY, TN 37604-5611
(423) 439-7371
(423) 232-0420
Mailing address
PO BOX 70403, JOHNSON CITY, TN 37614-1703
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15468
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15468
APN
TN
01
—
176776
EMT LICENSE
TN
01
—
RN132686
RN LICENSE
TN
Enumeration date
08/19/2010
Last updated
12/20/2021
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