Individual
AMANDA GAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1000 BLYTHE BLVD, CMC ANNEX 1ST FLOOR, CHARLOTTE, NC 28203-5812
(704) 355-0720
(704) 355-5948
Mailing address
PO BOX 601643, CHARLOTTE, NC 28260-1643
(704) 355-0720
(704) 355-5948
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
229546
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679905574
—
NC
05
—
NP2540
—
SC
Enumeration date
08/01/2013
Last updated
01/06/2014
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