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Individual

AMANDA CARVER MERRITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
640 MAIN ST N, PEARSON, GA 31642
(912) 422-3131
(912) 422-3180
Mailing address
204 E 4TH ST, OCILLA, GA 31774-1539
(229) 468-9166
(229) 468-9188

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN201661
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0003161765A
GA
Enumeration date
06/09/2015
Last updated
10/02/2020
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