Individual
MRS. AMANDA MARIE PANCHAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Contact information
Practice address
702 CANTON ROAD, MARIETTA, GA 30060
(770) 428-4486
(770) 425-6005
Mailing address
702 CANTON ROAD, MARIETTA, GA 30060
(770) 428-4486
(770) 425-6005
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN146197
GA
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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